bluuebunny/crossref_metadata_2025 huggingface dataset:
Proper motion measurements for stars up to 100 kpc with Subaru HSC and SDSS Stripe 82
Authors: Qiu Tian , Wang Wenting , Takada Masahiro , Yasuda Naoki , Ivezić Željko , Lupton Robert H , Chiba Masashi , Ishigaki Miho , Komiyama Yutaka
Published: December 2020

We present proper motion measurements for more than 0.55 million main-sequence stars, by comparing astrometric positions of matched stars between the multiband imaging data sets from the Hyper Suprime-Cam (HSC) Survey and the Sloan Digital Sky Survey (SDSS) Stripe 82. In doing this, we use 3 million galaxies to recalibrate the astrometry and set up a common reference frame between the two catalogues. The exquisite depth and the nearly 12 yr of time baseline between HSC and SDSS enable high-precision measurements of statistical proper motions for stars down to i ≃ 24. A validation of our method is demonstrated by the agreement with the Gaia proper motions, to the precision better than 0.1 mas yr−1. To retain the precision, we make a correction of the subtle effects due to the differential chromatic refraction in the SDSS images based on the comparison with the Gaia proper motions against colour of stars, which is validated using the SDSS spectroscopic quasars. Combining with the photometric distance estimates for individual stars based on the precise HSC photometry, we show a significant detection of the net proper motions for stars in each bin of distance out to 100 kpc. The two-component tangential velocities after subtracting the apparent motions due to our own motion display rich phase-space structures including a clear signature of the Sagittarius stream in the halo region of distance range [10, 35] kpc. We also measure the tangential velocity dispersion in the distance range 5–20 kpc and find that the data are consistent with a constant isotropic dispersion of 80 ± 10 km s−1. More distant stars appear to have random motions with respect to the Galactic Centre on average.
The mass of the Milky Way out to 100 kpc using halo stars
Authors: Deason Alis J , Erkal Denis , Belokurov Vasily , Fattahi Azadeh , Gómez Facundo A , Grand Robert J J , Pakmor Rüdiger , Xue Xiang-Xiang , Liu Chao , Yang Chengqun , Zhang Lan , Zhao Gang
Published: December 2020

We use a distribution function analysis to estimate the mass of the Milky Way (MW) out to 100 kpc using a large sample of halo stars. These stars are compiled from the literature, and the vast majority (${\sim } 98{{\ \rm per\ cent}}$) have 6D phase-space information. We pay particular attention to systematic effects, such as the dynamical influence of the Large Magellanic Cloud (LMC), and the effect of unrelaxed substructure. The LMC biases the (pre-LMC infall) halo mass estimates towards higher values, while realistic stellar haloes from cosmological simulations tend to underestimate the true halo mass. After applying our method to the MW data, we find a mass within 100 kpc of M (<100 kpc) = 6.07 ± 0.29 (stat.) ± 1.21 (sys.) × 1011 M⊙. For this estimate, we have approximately corrected for the reflex motion induced by the LMC using the Erkal et al. model, which assumes a rigid potential for the LMC and MW. Furthermore, stars that likely belong to the Sagittarius stream are removed, and we include a 5 per cent systematic bias, and a 20 per cent systematic uncertainty based on our tests with cosmological simulations. Assuming the mass–concentration relation for Navarro–Frenk–White haloes, our mass estimate favours a total (pre-LMC infall) MW mass of M200c = 1.01 ± 0.24 × 1012 M⊙, or (post-LMC infall) mass of M200c = 1.16 ± 0.24 × 1012 M⊙ when a 1.5 × 1011 M⊙ mass of a rigid LMC is included.
ALMA detects molecular gas in the halo of the powerful radio galaxy TXS 0828+193
Authors: Fogasy Judit , Knudsen K K , Drouart G , Gullberg B
Published: December 2020

Both theoretical and observational results suggest that high-redshift radio galaxies (HzRGs) inhabit overdense regions of the universe and might be the progenitors of local, massive galaxies residing in the centre of galaxy clusters. In this paper, we present CO(3–2) line observations of the HzRG TXS 0828+193 (z = 2.57) and its environment using the Atacama Large Millimeter/submillimeter Array. In contrast to previous observations, we detect CO emission associated with the HzRG and derive a molecular gas mass of $(0.9\pm 0.3)\times 10^{10}\, \rm M_{\odot }$. Moreover, we confirm the presence of a previously detected off-source CO emitting region (companion #1), and detect three new potential companions. The molecular gas mass of each companion is comparable to that of the HzRG. Companion #1 is aligned with the axis of the radio jet and has stellar emission detected by Spitzer. Thus, this source might be a normal star-forming galaxy or alternatively a result of jet-induced star formation. The newly found CO sources do not have counterparts in any other observing band and could be high-density clouds in the halo of TXS 0828+193 and thus potentially linked to the large-scale filamentary structure of the cosmic web.
Aspirin reduces sFlt-1-mediated apoptosis of trophoblast cells in preeclampsia
Authors: Zuo Qing , Zou Yanfeng , Huang Shiyun , Wang Tianjun , Xu Yetao , Zhang Tingting , Zhang Min , Ge Zhiping , Jiang Ziyan
Published: December 2020

Preeclampsia (PE) is a hypertensive disorder that occurs during pregnancy. Low-dose aspirin is used to reduce the occurrence of early-onset PE; however, the mechanisms are not clear. The aim of this study was to reveal the underlying mechanism of aspirin in reducing sFlt-1-mediated apoptosis of trophoblast cells in PE. Serum sFlt-1 and sEng profiles and placental oxidative stress levels were significantly decreased in PE patients treated with aspirin compared with untreated patients without it, whereas serum PLGF and placental SOD profiles were increased in PE patients with aspirin. Aspirin attenuated the role of sFlt-1 in oxidative stress and endothelial dysfunction and reduced apoptosis of trophoblasts by inactivating the NF-κB signalling pathway in HTR-8/SVneo trophoblast cells. Blood pressure, urine protein, swelling of the villous vessels and mitochondrial parameters were noted to be much better after aspirin administrated to sFlt-1 treated pregnant mice. In conclusion, aspirin reverses the endothelial dysfunction and oxidative stress caused by sFlt-1 and thus reduces apoptosis of preeclamptic trophoblasts by inactivating NF-κB signalling pathway.
Tobacco Advertising Features That May Contribute to Product Appeal Among US Adolescents and Young Adults
Authors: Moran Meghan Bridgid , Heley Kathryn , Czaplicki Lauren , Weiger Caitlin , Strong David , Pierce John
Published: December 2020

Introduction

Cigarette advertising is a causal agent of smoking uptake among young people. Although prior research links ad receptivity to tobacco product interest and use, little is known regarding the specific advertising tactics associated with increased product appeal among young people.

Methods

A national sample of 13–20 year-olds (N = 3688, youth) and 21–24 year-olds (N = 1556, young adults) in the US participated in an online survey in 2017 (mean age 18.1 years). The majority (72.0%) of youth and nearly half (44.8%) of young adults were never smokers. Participants were shown a cigarette ad, randomly assigned from a pool of 50 advertisements, and reported how much they liked the ad, and were curious about and interested in using the advertised product. All 50 advertisements were content analyzed for a variety of features. Data from the survey and content analysis were merged and mixed effects analyses used to identify the features associated with increased liking, curiosity, and interest in using, referred to collectively as product appeal.

Results

Presence of a sweepstakes offer was associated with increased liking, curiosity and interest among youth and curiosity and interest among young adults. Outdoors settings, flora imagery, natural descriptors, and environmental themes were associated with increased appeal. Price reductions (eg, coupons) were associated with decreased appeal among youth.

Conclusions

This study identified several advertising tactics associated with increased appeal among youth and young adults. If additional research confirms these findings, the U.S. Food and Drug Association should consider restricting use of these tactics in tobacco advertising.

Implications

This study's findings provide insight into features of cigarette ads that appeal to youth and young adults. Overall, the presence of sweepstakes appealed to youth and young adults and outdoors and environmental themes were particularly appealing to young adults. Such tactics could serve to further brand engagement, improve brand image and lead to initiation or escalation of use. If confirmatory studies further demonstrate the effects of the tactics identified in this study on youth product appeal, U.S. Food and Drug Administration should consider using its authority to restrict the use of youth-appealing tactics.
Art and Pediatric Orthopaedics: Velazquez, an Artist of Stature
Authors: Rebello Gleeson , Joseph Benjamin
Published: December 2020

Diego Velazquez painted several dwarfs employed at the Royal Court of Spain and one of the best known among them is the painting of Sebastian de Morra, a court jester. The clarity of the painting enables the reader to make a diagnosis of achondroplasia.
Fingerprick Autologous Blood in the Treatment of Severe Dry Eyes and Ocular Surface Disease
Authors: Erikitola Ore-oluwa , Williams Olayinka , Fern Alasdair , Lyall Douglas
Published: December 2020

Purpose:

To evaluate the efficacy of autologous blood eye drops in patients diagnosed with severe ocular surface disease and dry eye who were unresponsive to conventional therapy and who would otherwise be considered for autologous serum eye drops.

Methods:

A total of 38 eyes of 19 patients (15 women and 4 men) with ocular surface disease and severe dry eye refractory to conventional treatment were treated with fingerprick autologous blood 4 times daily for 6 months. Follow-up visits occurred at 1-, 3-, and 6-month intervals. At each visit, visual acuity, Oxford Grading Scheme score, tear film break-up time, Schirmer test, and ocular surface disease index were measured.

Results:

There was a significant improvement in the ocular surface staining score at all time gates. The mean score at presentation was 2.13, and this improved to 1.50 at 1 month (P < 0.001), 1.29 at 3 months (P < 0.01), and 1.42 at 6 months (P < 0.01). There was an improvement in tear film break-up time from 4.75 seconds at baseline to 6.79 seconds at 3 months (P < 0.01) and 7.0 seconds at 6 months (P < 0.001). An improvement in the Schirmer test was only found at 6 months with an improvement from 3.67 mm to 13.33 mm (P < 0.05). There was no statistical change in visual acuity at any time gate or ocular surface disease index score, although 83% of patients reported an improvement in their symptoms at 6 months. There were no adverse events reported.

Conclusions:

Fingerprick autologous blood is an effective, readily accessible, and safe therapy for the treatment of recalcitrant cases of severe ocular surface disease and dry eye unresponsive to conventional therapy.
Algorithm for Treatment of Supernumerary Nasal Tooth
Authors: de Souza Santos Anderson Maikon , de Lima-Neto Tiburtino José , Mendes Bruno Coelho , Hochuli Vieira Eduardo , Sverzut Alexander Tadeu , Luna Anibal Henrique Barbosa
Published: December 2020

The presence of a tooth in the nasal cavity is a rare condition. There is an even more rare association, which is the presence with the mineral's deposition and formation of rhinoliths. This report shows a case of rare nasal tooth associated with rhinolithiasis and describes its surgical treatment based on an algorithm. The diagnosis was made by endoscopy with the aid of computed tomography, followed by surgical endoscopy excision. The algorithm and the proposed treatment was successful in its execution and the patient presents no complaints or complications at 3 years after surgery.
The Impact of a 9-Month Booster Training Using Rapid Cycle Deliberate Practice on Pediatric Resident PALS Skills
Authors: Surapa Raju Sai , Tofil Nancy M. , Gaither Stacy L. , Norwood Carrie , Zinkan J. Lynn , Godsey Veronica , Aban Inmaculada , Xue Yumo , Rutledge Chrystal
Published: December 2020

Introduction

The impact of booster training on pediatric resuscitation skills is not well understood. Rapid cycle deliberate practice (RCDP) to supplement pediatric advanced life support (PALS) training is beginning to be used to improve resuscitation skills. We tested the impact of booster RCDP training performed at 9 months after initial RCDP training on pediatric resuscitation skills of pediatric residents.

Objective

This study evaluated the impact of a 9-month RCDP booster training on PALS skills compared with usual practice debriefing (plus/delta) after an initial RCDP training session for PALS-certified pediatric interns.

Methods

All pediatric interns at a single institution were invited to a 45-minute RCDP training session after their initial PALS certification. The PALS performance score and times for key events were recorded for participants immediately before and after the RCDP training as well as 6, 9, and 12 months after the RCDP training. Learners were randomized to an RCDP intervention and usual practice (plus/delta) group. The intervention group received booster RCDP training after their 9-month assessment.

Results

Twenty eight of 30 residents participated in the initial training with 22 completing randomization at 9 months. There was no significant difference in 12-month PALS median performance scores after the booster training between the intervention and usual practice groups (83% vs. 94%, P = 0.31). There was significant improvement in PALS performance score from 51 ± 27% pre–initial RCDP assessment to 93 ± 5% post–initial RCDP training (P < 0.001). There were significant improvements in individual skills from pre– to post–initial RCDP testing, including time to verbalize pulseless, start compressions, and attach defibrillation pads (P < 0.001).

Conclusions

Rapid cycle deliberate practice booster training versus plus/delta training at 9-month post–initial RCDP training did not alter 12-month performance. However, RCDP is effective at improving PALS performance skills, and this effect is maintained at 6, 9, and 12 months. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.
Long-term Follow-up of a Randomized Clinical Trial Comparing Endovascular Revascularization Plus Supervised Exercise With Supervised Exercise Only for Intermittent Claudication
Authors: Klaphake Sanne , Fakhry Farzin , Rouwet Ellen V. , van der Laan Lijckle , Wever Jan J. , Teijink Joep A. , Hoffmann Wolter H. , van Petersen Andre , van Brussel Jerome P. , Stultiens Guido N. , Derom Alex , den Hoed Ted T. , Ho Gwan H. , van Dijk Lukas C. , Verhofstad Nicole , Orsini Mariella , Hulst Ingrid , van Sambeek Marc R. , Rizopoulos Dimitris , van Rijn Marie Jose J. E. , Verhagen Hence J. M. , Hunink Myriam G. M.
Published: December 2020

Objective: The goal of this study was to assess the long-term effectiveness of combination therapy for intermittent claudication, compared with supervised exercise only.

Background: Supervised exercise therapy is recommended as first-line treatment for intermittent claudication by recent guidelines. Combining endovascular revascularization plus supervised exercise shows promising results; however, there is a lack of long-term follow-up.

Methods: The ERASE study is a multicenter randomized clinical trial, including patients between May 2010 and February 2013 with intermittent claudication. Interventions were combination of endovascular revascularization plus supervised exercise (n = 106) or supervised exercise only (n = 106). Primary endpoint was the difference in maximum walking distance at long-term follow-up. Secondary endpoints included differences in pain-free walking distance, ankle-brachial index, quality of life, progression to critical limb ischemia, and revascularization procedures during follow-up. This randomized trial report is based on a post hoc analysis of extended follow-up beyond that of the initial trial. Patients were followed up until 31 July 2017. Data were analyzed according to the intention-to-treat principle.

Results: Median long-term follow-up was 5.4 years (IQR 4.9–5.7). Treadmill test was completed for 128/212 (60%) patients. Whereas the difference in maximum walking distance significantly favored combination therapy at 1-year follow-up, the difference at 5-year follow-up was no longer significant (53 m; 99% CI–225 to 331; P = 0.62). No difference in pain-free walking distance, ankle-brachial index, and quality of life was found during long-term follow-up. We found that supervised exercise was associated with an increased hazard of a revascularization procedure during follow-up (HR 2.50; 99% CI 1.27–4.90; P < 0.001). The total number of revascularization procedures (including randomized treatment) was lower in the exercise only group compared to that in the combination therapy group (65 vs 149).

Conclusions: Long-term follow up after combination therapy versus supervised exercise only, demonstrated no significant difference in walking distance or quality of life between the treatment groups. Combination therapy resulted in a lower number of revascularization procedures during follow-up but a higher total number of revascularizations including the randomized treatment.

Trial Registration: Netherlands Trial Registry Identifier: NTR2249
Does Essential Tremor Alter the Axonal Excitability Properties of Lower Motor Neurons?
Authors: Kim Yerim , Kim Young Eun , Lee Joo Young , Ma Hyeo-Il , Shim Soon Kyung , Yoon Sun min , Bae Jong Seok
Published: December 2020

Purpose:

Automated nerve excitability testing has identified that the altered excitability of lower motor neuron (LMN) axons in central diseases is because of trans-synaptic plasticity. Essential tremor (ET) is considered a central disorder caused by an altered cerebellar circuit. This study aimed to identify alterations in the excitability of distal motor axons in subjects with ET, with the intention of clarifying whether a trans-synaptic mechanism or LMN adaptation for tremor affects the LMNs of subjects with ET.

Methods:

Twenty-one consecutive patients diagnosed with ET underwent a clinical and electrophysiological evaluation. For the enrolled cases and 45 age- and gender-matched healthy controls, automated nerve excitability testing with threshold tracking techniques (QTRACS software with TRONDF multiple-excitability protocol) was used to evaluate multiple nerve excitability indices in distal median nerve motor axons.

Results:

The automated protocol calculated the strength–duration time constant, parameters of threshold electrotonus and current–threshold relationship, and the recovery cycle of excitability. Comparisons of the automated nerve excitability testing parameters revealed no significant differences between the ET and control groups in any of strength–duration time constant, threshold electrotonus, current–threshold relationship, and recovery cycle, whereas the rheobase was higher in the ET group (3.4 ± 1.1 vs. 2.3 ± 1.1, mean ± standard error mean; P < 0.01).

Conclusions:

With the exception of an increased rheobase in ET subjects, no significant differences were observed in LMN excitability between the ET subjects and their controls. The extent of plasticity or adaptation in LMNs may be limited to a major change in central processes that exert marked effects on the pool of LMNs.
Impact of small sample sizes on the internal quality control: statistical uncertainties in the determination of root mean square deviations with respect to the sample mean (RMSD) or to a target value (RMSTD)
Authors: Beier Christian
Published: December 2020

Insufficient statistics due to small considered sample sizes can cause distinct problems in internal quality control (IQC) approaches. This issue concerns most of the currently applied IQC concepts either directly (if a root-mean-square-deviation metric is evaluated) or indirectly (if the IQC concept facilitates a standard deviation that was self-evaluated based on a very limited number (n≤30) of control measures). In clinical chemistry a famous example for the latter case is the common implementation of the Westgard Sigma Rules approach.

This study quantifies the statistical uncertainties in the determination of root mean square (total) deviations related to the sample mean (RMSD) or to a target value (RMSTD). It is clearly shown that RMS(T)D values based on small data sets with n<50 samples are accompanied by a significant statistical uncertainty that needs to be considered in adequate IQC limit definitions. Two mathematical models are derived to reliably estimate an optimal adaptation function to adjust IQC limits to short charts of control measures.

This article provides the theoretical background for the novel IQC method “Statistical Monitoring by Adaptive RMSTD Tests” (SMART) intended to monitor limited available numbers of recent control measures (usually n<20). The study also addresses a general problem in specificity of an IQC resulting from too small sample sizes during the evaluation period of the applied in-control standard deviation.
A demonstration of cone function plasticity after gene therapy in achromatopsia
Authors: Farahbakhsh Mahtab , Anderson Elaine J. , Rider Andy , Greenwood John A. , Hirji Nashila , Zaman Serena , Jones Pete R. , Schwarzkopf D. Samuel , Rees Geraint , Michaelides Michel , Dekker Tessa M.
Published: December 2020

Recent advances in regenerative therapy have placed the treatment of many previously incurable eye diseases within arms-reach (Ciulla et al., 2020). Achromatopsia (ACHM) is a severe monogenic heritable retinal disease that disrupts cone function from gestation, leaving patients with complete colour blindness, low acuity, photosensitivity, and nystagmus (Hirji, Aboshiha, et al., 2018). In non-primate animal models of ACHM, retinal gene-replacement therapy has successfully induced cone function in the young (Alexander et al., 2007; Carvalho et al., 2011), but it was yet to be determined if and when these therapies could effectively impact cone-mediated pathways in the human brain. Here we demonstrate in children with ACHM that gene therapy can yield substantial improvement in cone-mediated vision, via cascading effects on signal transmission from retina to cortex. To measure the effects of treatment in children with ACHM (CNGA3- and CNGB3-associated, all aged 10+ years), we developed novel visual stimuli, calibrated to selectively activate cone photoreceptors. We used these in behavioural psychophysics and functional MRI with population receptive field mapping, pre- and post-treatment. The results of treatment, contextualized against data from 12 untreated ACHM patients and 25 normal-sighted, revealed that six months post-therapy, two patients displayed novel responses to our cone-selective stimuli in the visual cortex, with a retinotopic organisation characteristic of normal-sighted individuals, not present in untreated ACHM. This was paired with significant improvement in cone-mediated perception specific to the treated eye, and self-reports of improved vision. Two other patients did not show a post-treatment effect, potentially reflecting individual differences in therapeutic outcome. Together, these data show that gene replacement therapy in humans with ACHM can activate dormant cone pathways despite long-term deprivation. This offers great promise for regenerative therapies, and their ability to trigger the neural plasticity needed to cure congenital vision loss in human patients.
Functional connectivity of dorsolateral prefrontal cortex predicts cocaine relapse
Authors: Zhai Tianye , Salmeron Betty Jo , Gu Hong , Adinoff Bryon , Stein Elliot A. , Yang Yihong
Published: December 2020

Background

Relapse is one of the most perplexing problems of addiction. The dorsolateral prefrontal cortex (DLPFC) is crucially involved in numerous cognitive and affective processes that are implicated in phenotypes of addiction, and is one of the most frequently reported brain regions with aberrant functionality in substance use disorders. However, the DLPFC is an anatomically large and functionally heterogeneous region, and the specific DLPFC-based circuits that contribute to drug relapse remain unknown.

Methods

We systematically investigated the relationship of cocaine relapse with 98 DLPFC functional circuits defined by evenly sampling the entire bilateral DLPFC in a cohort of cocaine dependent patients (n=43, 5F) following a psychosocial treatment intervention. A Cox regression model was utilized to predict relapse likelihood based on DLPFC functional connectivity strength.

Results

Functional connectivity from 3 of the 98 DLPFC loci, one on the left and two on the right hemisphere, significantly predicted cocaine relapse with an accuracy of 83.9%, 84.7% and 85.4%, respectively. Combining all three significantly improved prediction validity to 87.5%. Protective and risk circuits related to these DLPFC loci were identified that are known to support “bottom up” drive to use drug and “top down” control over behavior together with social emotional, learning and memory processing.

Conclusion

Three DLPFC-centric circuits were identified that predict relapse to cocaine use with high accuracy. These functionally distinct DLPFC-based circuits provide insights into the multiple roles played by the DLPFC in cognitive and affective functioning that affects treatment outcome. The identified DLPFC loci may serve as potential neuromodulation targets for addiction treatment and as clinically relevant biomarkers of its efficacy.
Identifying communities at risk for COVID-19-related burden across 500 U.S. Cities and within New York City
Authors: Patel Chirag J , Deonarine Andrew , Lyons Genevieve , Lakhani Chirag M , Manrai Arjun K
Published: December 2020

Background

While it is well-known that older individuals with certain comorbidities are at highest risk for complications related to COVID-19 including hospitalization and death, we lack tools to identify communities at highest risk with fine-grained spatial and temporal resolution. Information collected at a county level obscures local risk and complex interactions between clinical comorbidities, the built environment, population factors, and other social determinants of health.

Methods

We develop a robust COVID-19 Community Risk Score (C-19 Risk Score) that summarizes the complex disease co-occurrences for individual census tracts with unsupervised learning, selected on their basis for association with risk for COVID complications, such as death. We mapped the C-19 Risk Score onto neighborhoods in New York City and associated the score with C-19 related death. We further predict the C-19 Risk Score using satellite imagery data to map the built environment in C-19 Risk.

Results

The C-19 Risk Score describes 85% of variation in co-occurrence of 15 diseases that are risk factors for COVID complications among 26K census tract neighborhoods (median population size of tracts: 4,091). The C-19 Risk Score is associated with a 40% greater risk for COVID-19 related death across NYC (April and September 2020) for a 1SD change in the score (Risk Ratio for 1SD change in C19 Risk Score: 1.4, p < .001). Satellite imagery coupled with social determinants of health explain nearly 90% of the variance in the C-19 Risk Score in the United States in held-out census tracts (R2 of 0.87).

Conclusions

The C-19 Risk Score localizes COVID-19 risk at the census tract level and predicts COVID-19 related morbidity and mortality.
Evaluation of the Effect of Zinc, Quercetin, Bromelain and Vitamin C on COVID-19 Patients
Authors: Kamel Amr , Abdelseed Heba , Albalawi Yousef , Aslsalameen Eman , Almutairi Yousef , Alkattan Abdullah
Published: December 2020

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new strain of coronavirus. There are three phases of COVID-19: early infection stage, pulmonary stage and hyper-inflammation stage respectively. It is important to prevent lung or other organs injuries by preventing phase-II and phase-III via pharmacological or non-pharmacological treatments. This was a case series study done on twenty-two patients confirmed to be infected with SARS-CoV-2 and diagnosed with COVID-19. Patients in this study have been used quercetin 800 mg, bromelain 165 mg, zinc acetate 50 mg and ascorbic acid 1 g once daily as supplements for 3 to 5 days during SARS-CoV-2 infection. The aim of this study is to evaluate the safety and efficacy of quercetin, bromelain, zinc and ascorbic acid combination supplements on patients with COVID-19. The mean levels of WBC, ANC, ALC, AMC and AST were normal among all included patients before and after taking quercetin, bromelain, zinc and ascorbic acid supplements (P-value > 0.05). Quercetin 800 mg, bromelain 165 mg, zinc acetate 50 mg and ascorbic acid 1 g once daily supplements were safe for patients infected with SARS-CoV-2 and may prevent poor prognosis. Randomized clinical trials needed in the future to ensure the efficacy of quercetin, bromelain, zinc and vitamin c combination.
Effectiveness of prolotherapy vs local anesthetic infiltration guided by ultrasound in the treatment of shoulder pain syndrome
Authors: Lira-Lucio Juan A. , Ochoa-Gaítan Guillermo , Hernández-Escobar Lizeth , Padilla-Rivera Christian I. , Hernández Porras Berenice C. , Juarez-Lemus Ángel M. , Ochoa-Millan Jose Guillermo , Jimenez-Contreras Roberto J. , Roldán-Rodríguez Enrique
Published: December 2020

BACKGROUND

Chronic Shoulder Pain (CSP) is a health problem that affects almost 67% of the general population. Almost a third of patients with acute shoulder pain syndrome don’t respond to initial therapy with analgesics and need interventional therapy. Corticosteroid injection is the standard therapy. Prolotherapy has been demonstrated to be effective in other chronic pain syndromes, but not in CSP. The aim of this study was to determine the effectiveness of prolotherapy compared to local anesthetic injection in the treatment of chronic shoulder pain

METHODS

Retrospective and comparative study of 77 patients from the National Institute of Oncology in Mexico City who received treatment for Chronic Shoulder Pain guided by ultrasound between 2017-2019. 57 patients were kept in the study for further analysis. 39 received infiltration with corticosteroids and 17 prolotherapy. Effectiveness of therapies was determined based on the decrease in VAS score in next follow-up session. Statistical analysis were performed with SPSS and RStudio Software.

RESULTS

51% of patients with Chronic Shoulder Pain were unemployed. 84% of the patients needed 3 different types of analgesics before they received ultrasound guided local treatment. Prolotherapy was as efficient as local anesthetic injection, no matter basal pain severity or underlying shoulder diagnosis, despite prolotherapy being more used as treatment for Rotator Cuff Tendinopathy.

CONCLUSIONS

Prolotherapy and corticosteroid injection guided by ultrasound have the same efficacy in pain relief for chronic shoulder pain in oncologic patients.
Building a Best-in-Class Automated De-identification Tool for Electronic Health Records Through Ensemble Learning
Authors: Murugadoss Karthik , Rajasekharan Ajit , Malin Bradley , Agarwal Vineet , Bade Sairam , Anderson Jeff R. , Ross Jason L. , Faubion William A. , Halamka John D. , Soundararajan Venky , Ardhanari Sankar
Published: December 2020

The natural language portions of electronic health records (EHRs) communicate critical information about disease and treatment progression. However, the presence of personally identifiable information (PII) in this data constrains its broad reuse. Despite continuous improvements in methods for the automated detection of PII, the presence of residual identifiers in clinical notes requires manual validation and correction. However, manual intervention is not a scalable solution for large EHR datasets. Here, we describe an automated de-identification system that employs an ensemble architecture, incorporating attention-based deep learning models and rule-based methods, supported by heuristics for detecting PII in EHR data. Upon detection of PII, the system transforms these detected identifiers into plausible, though fictional, surrogates to further obfuscate any leaked identifier. We evaluated the system with a publicly available dataset of 515 notes from the I2B2 2014 de-identification challenge and a dataset of 10,000 notes from the Mayo Clinic. In comparison with other existing tools considered best-in-class, our approach outperforms them with a recall of 0.992 and 0.994 and a precision of 0.979 and 0.967 on the I2B2 and the Mayo Clinic data, respectively. The automated de-identification system presented here can enable the generation of de-identified patient data at the scale required for modern machine learning applications to help accelerate medical discoveries.
COVID-19 deaths detected in a systematic post-mortem surveillance study in Africa
Authors: Mwananyanda Lawrence , Gill Christopher J. , MacLeod William , Kwenda Geoffrey , Pieciak Rachel , Mupila Zachariah , Mupeta Francis , Forman Leah , Ziko Luunga , Etter Lauren , Thea Donald
Published: December 2020

Objectives

Limited SARS CoV 2 testing in many African countries has constrained availability of data on the impact of COVID-19 (CV19). To address this gap, we conducted a systematic post-mortem surveillance study to directly measure the fatal impact of CV19 in an urban African population.

Design

We enrolled deceased individuals at the University Teaching Hospital (UTH) Morgue in Lusaka, Zambia. We obtained nasopharyngeal swabs for testing via reverse-transcriptase quantitative PCR (RT-qPCR) against the SARS-2 Coronavirus. We stratified deaths by CV19 status, by location, age, sex, and underlying risk factors.

Setting

UTH is Zambia’s largest tertiary care referral hospital and its morgue registers ∼80% of Lusaka’s deaths.

Participants

Participants of all ages were enrolled if within 48 hours of death and if the next of kin or representative provided written informed consent.

Results

We enrolled 372 participants between June and September 2020, and had PCR results for 364 (99.5%). CV19 was detected in 70/364 (19.2%). The median age for CV19+ deaths was 48 years (IQR 36-72 years) and 70% were male. Most CV19+ deaths (51/70, 72.8%) occurred in the community; none had been tested for CV19 antemortem. Among the 19/70 facility deaths, six were tested antemortem. Among the 52/70 CV19 deaths with symptoms data, 44/52 had typical symptoms of CV19 (cough, fever, shortness of breath), of whom only five were tested antemortem. We identified CV19 among seven children; only one had been tested antemortem. The proportion of CV19+ deaths increased with age, but 75.7% of CV19+ deaths were aged <60 years. The five most common co-morbidities among CV19+ deaths were: tuberculosis (31.4%); hypertension (27.1%); HIV/AIDS (22.9%); alcohol use (17.1%); and diabetes (12.9%).

Conclusions

Contrary to expectations, CV19+ deaths were common in Lusaka. The majority occurred in the community where testing capacity is lacking. Yet few who died at facilities were tested, despite presenting with typical symptoms of CV19. Therefore, CV19 cases were under reported because testing was rarely done, not because CV19 was rare. If our data are generalizable, the impact of CV19 in Africa has been vastly underestimated.
Prevalence of bacterial pathogens and potential role in COVID-19 severity in patients admitted to intensive care units in Brazil
Authors: de Carvalho Fabíola Marques , Lemos Leandro Nascimento , Ciapina Luciane Prioli , Moreira Rennan Garcias , Gerber Alexandra , Guimarães Ana Paula C , Fereguetti Tatiani , de Andrade Zambelli Virgínia Antunes , Avila Renata , de Almeida Tailah Bernardo , da Silva Lima Jheimson , Coutinho Barroso Shana Priscila , Teixeira Mauro Martins , Souza Renan Pedra , Cardoso Cynthia Chester , Aguiar Renato Santana , de Vasconcelos Ana Tereza Ribeiro
Published: December 2020

Secondary bacterial and fungal infections are associated with respiratory viral infections and invasive mechanical ventilation. In Coronavirus disease 2019 (COVID-19), lung injury by SARS-CoV-2 and impaired immune response can provide a favorable environment for microorganism growth and colonization in hospitalized individuals. Recent studies suggest that secondary bacterial pneumonia is a risk factor associated with COVID-19. In Brazil, knowledge about microbiota present in COVID-19 patients is incipient. This work describes the microbiota of 21 COVID-19 patients admitted to intensive care units from two Brazilian centers. We identified respiratory, nosocomial and bacterial pathogens as prevalent microorganisms. Other bacterial opportunistic and commensal species are also represented. Virulence factors of these pathogenic species, metabolic pathways used to evade and modulate immunological processes and the interconnection between bacterial presence and virulence in COVID-19 progression are discussed.

Article Summary Line

We identified respiratory, nosocomial and bacterial pathogens as prevalent microorganisms in 21 Brazilian COVID-19 patients admitted to Intensive Care Units. Pathogen virulence factors and immune response evasion metabolic pathways are correlated to COVID-19 severity.
The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants
Authors: Kværner Ane Sørlie , Birkeland Einar , Bucher-Johannessen Cecilie , Vinberg Elina , Nordby Jan Inge , Kangas Harri , Bemanian Vahid , Ellonen Pekka , Botteri Edoardo , Natvig Erik , Rognes Torbjørn , Hovig Eivind , Lyle Robert , Ambur Ole Herman , de Vos Willem M. , Bultman Scott , Hjartåker Anette , Landberg Rikard , Song Mingyang , Ursin Giske , Randel Kristin Ranheim , de Lange Thomas , Hoff Geir , Holme Øyvind , Berstad Paula , Rounge Trine B.
Published: December 2020

Background

Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions.

Methods

The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50-74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period.

Discussion

The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome- based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high.

Trial Registration

ClinicalTrials.gov Identifier: NCT01538550
THE SEARCH FOR AN ASSOCIATION OF HLA ALLELES AND COVID-19 RELATED MORTALITY IN THE RUSSIAN POPULATION
Authors: Cheranev Valery , Bulusheva Irina , Vechorko Valery , Korostin Dmitriy , Rebrikov Denis
Published: December 2020

HLA genes play a pivotal role in an immune response via the presentation of pathogen peptides in a complex on the surface of cells of a host organism. Here, we studied the association of class I and class II genes with the severity of COVID-19 infection and HLA allele variants.

We performed high-resolution sequencing of class I and class II HLA genes using the sample population of 147 patients who died of COVID-19 and statistically compared our results with the frequencies of the HLA genotypes in a control population of 270 samples.

The obtained data demonstrated that 51:05 and 15:18 alleles from locus B* are statistically significantly associated with COVID-19 severity, while C*14:02 allele correlates with the probability of death from COVID-19 for patients without comorbidities.
Modelling the Potential Role of Media Campaigns on the Control of Listeriosis
Authors: Chukwu C. W. , Nyabadza F. , Fatmawati
Published: December 2020

Human Listeria infection is a food-borne disease caused by the consumption of contaminated food products by the bacterial pathogen, Listeria. In this paper, we propose a mathematical model to analyze the impact of media campaigns on the spread and control of Listeriosis. The model exhibited three equilibria namely; disease-free, Listeria-free and endemic equilibria. The food contamination threshold (ℛf) is determined and the local stability analyses of the model discussed. Sensitivity analysis is done to determine the model parameters that most affect the severity of the disease. Numerical simulations were carried out to assess the role of media campaigns on the Listeriosis spread. The results show that; an increase in the intensity of the media awareness campaigns, the removal rate of contaminated food products, a decrease in the contact rate of Listeria by humans results in fewer humans getting infected, thus leading to the disease eradication. An increase in the depletion of media awareness campaigns results in more humans being infected with Listeriosis. These findings may significantly impact policy and decision making in the control of Listeriosis disease.
Relative effectiveness of non-surgical interventions for pain management in knee osteoarthritis: a protocol for a component network meta-analysis of randomised controlled trials
Authors: Thompson Trevor , Ahmed Bawan , Weldon Sharon , Efthimiou Orestis , Stubbs Brendon
Published: December 2020

Introduction

Knee osteoarthritis is a chronic degenerative disease and the most common form of osteoarthritis, and is associated with significant chronic pain, disability and impairment of quality of life. Currently, there is no cure for knee osteoarthritis and pain management and improving quality of life are the main therapeutic goals. The objective of this study is to evaluate the relative efficacy and acceptability of currently available interventions using network meta-analysis in order to provide a comprehensive evidence base to guide future clinical treatment guidelines.

Methods and analysis

A comprehensive literature search of major electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) and clinical trial registries will be undertaken to identify randomised control trials (RCTs) of interventions listed in NICE guidelines for the treatment of knee osteoarthritis in adults. We will perform a network meta-analysis (NMA) to estimate relative intervention effects across the whole treatment network. If any studies use multicomponent interventions, we will employ a component network meta-analysis (CNMA) model to estimate the contribution of individual components. The quality of evidence will be assessed using the Confidence in Network Meta-Analysis (CINeMA) approach, which is based on the traditional GRADE framework adapted for NMA. Risk of bias will be assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool for RCTs.

Ethics and dissemination

This study does not require ethical approval. Findings will be submitted to a peer-reviewed journal.

PROSPERO registration number

CRD42020184192.

ARTICLE SUMMARY

Strengths and limitations of this study

This will be the first network meta-analysis to assess relative effectiveness of interventions listed in NICE guidelines for pain management in knee osteoarthritis

The study will provide an evidence base to inform future clinical guidelines and treatment decision making

If relevant data are available, we will estimate the contribution of individual components in multicomponent interventions

Quality of evidence underlying all treatments will be assessed

Not all treatments will be evaluated if data are limited or we deem that network meta-analysis assumptions are violated
Psychosocial Factors of Stigma and Relationship to Healthcare Service among Adolescents Living With HIV/AIDS in Kano State, Nigeria
Authors: Amos Oladunni Abimbola , Sina-Odunsi Ayomide Busayo , Nuga Boyiga Bodinga , Adebisi Yusuff Adebayo , Bolarinwa Obasanjo Afolabi , Adeola Adesina Adetoun , Lucero-Prisno Don Eliseo
Published: December 2020

Background

Stigma associated with HIV shapes all aspect of prevention and treatment, yet there are limited data on how HIV-infected adolescents are affected by stigma. Stigma increases risk of psychological problems among HIV-infected individuals which can affect access to treatment and social support services. This study is aimed at identifying psychosocial factors of stigma and relationship to healthcare services among adolescents on antiretroviral therapy (ART) in Gwale Local Government Area (LGA) of Kano state, Nigeria.

Methods

A facility based cross-sectional survey was carried out from January 26 to February 28, 2020 across six health facilities providing ART service in Gwale local government. A structured interviewer-administered questionnaire was used to collect the data. ART clients attending clinics were interviewed following an informed verbal consent. Descriptive statistics was used to summarize the data and results are presented using simple frequency tables and percentages. Upon completion of univariate analysis, the data was analyzed at the bivariate level using chi-square test to determine associations between different variables.

Results

One hundred and eight (108) clients voluntarily participated in the study of which 54 (50%) are male respondents and 54 (50%) are female respondents. Under the internalized stigma item, 67% of HIV-infected adolescents who have lost father or mother to AIDS reported feeling less valuable than other children who are not infected with HIV. Under the perceived stigma items, 86% of participants who have lost father or mother to AIDS reported to have excluded themselves from health services and social activities in the last twelve months due to fear of being insulted. Under the experienced stigma items, 62% of participants who have lost father or mother to AIDS reported to have been avoided by friends and colleagues in the last twelve months.

Conclusion

The study revealed that loss of intimate relation (father or mother) to AIDS and equal treatment with other HIV negative siblings were found to be significantly associated with the three forms of stigma (internalized stigma, perceived stigma and experienced stigma) including access to healthcare services. There is need for social and psychological support programs among HIV-infected adolescents.