bluuebunny/crossref_metadata_2025 huggingface dataset:
Epstein-Barr virus associated hepatic smooth muscle tumor in a patient with acquired immunodeficiency syndrome
Authors: Zhou Qihui , Wu Fengtian , Guo Yongzheng , Zhu Biao
Published: May 2020

Introduction:

Epstein-Barr virus (EBV) associated smooth muscle tumors (SMTs) usually present under the condition of immunosuppression, including congenital immunodeficiency syndrome-SMT, post-transplantation-SMT and HIV-SMT. HIV-SMTs are most likely to invade the central nervous system, followed by the liver, lungs, and other locations.
[1]
Many laboratory techniques, including serological techniques, polymerase chain reaction and immunohistochemistry (IHC), are employed to determine the aetiologies of these tumours. With respect to therapy, surgical resection is the main treatment. In patients with immunodeficiency, improving immune status is significant for defending against other viruses. We describe a case of the primary focus of SMT in the liver of HIV-positive patient without any metastasis.

Patient concerns:

A young male HIV-positive patient complained of fever and abdominal pain for 2 months.

Diagnosis:

IHC of liver tissue confirmed the finding: EBV-related smooth muscle tumor.

Interventions:

Given the patient's general condition, he was not a suitable candidate for surgical resection. He was given antibiotics, antifungal agents and EBV-directed agents to control infection as well as highly active antiretroviral therapy to enhance the immunity.

Outcomes:

The patient's symptoms improved. He was discharged.

Conclusions:

In conclusion, EBV-related HIV-SMTs is a rare neoplasm found in the liver among immunodeficient patients. This case highlights that a variety of examinations such as IHC for smooth muscle markers (smooth muscle actin and desmin) and EBER, as well as polymerase chain reaction for EBV DNA should be done when diagnoses are ambiguous.
Increased thalamocortical connectivity to the medial prefrontal cortex with recovery of impaired consciousness in a stroke patient
Authors: Jang Sung Ho , Seo You Sung , Lee Sung Jun
Published: May 2020

Rationale:

We report a stroke patient who showed increased thalamocortical connectivity to the medial prefrontal cortex (mPFC) with recovery of impaired consciousness that was demonstrated on diffusion tensor tractography (DTT) of the ascending reticular activating system (ARAS).

Patients concerns:

A 48-year-old male patient underwent craniectomy and hematoma removal for spontaneous intracerebral hemorrhage in the right basal ganglia and thalamus. When he started rehabilitation at 5 weeks after onset he was in a vegetative state with a Coma Recovery Scale-Revised score of 6.

Diagnoses:

The patient was diagnosed spontaneous intracerebral hemorrhage in the right basal ganglia and thalamus.

Interventions:

He underwent comprehensive rehabilitation including neurotropic durgs, transcranial direct current stimulation, and repetitive transcranial magnetic stimulation of the left prefrontal lobe (Brodmann area 10).

Outcomes:

After 5 weeks of rehabilitation, the patient had recovered to a nearly normal conscious state with a Coma Recovery Scale-Revised score of 22. On 10-week DTT, thickening of the lower dorsal ARAS was observed on both sides compared with 5-week DTT. Decreased neural connectivity to the left PFC was observed on 5-week DTT whereas decreased neural connectivity to the left PFC was increased on 10-week DTT, especially the mPFC.

Lessons:

Increased thalamocortical connectivity to the mPFC was demonstrated in a stroke patient who showed concomitant recovery from a vegetative state to a nearly normal conscious state. The results suggest that the increased neural connectivity to the mPMC contributed to recovery of consciousness in this patient.
Treatment of slow transit constipation-induced ileus during pregnancy by colectomy with ileorectal anastomosis
Authors: Wang Rui , Su Qi , Yan Zhaopeng
Published: May 2020

Introduction:

Slow transit constipation is a major cause of chronic constipation. During pregnancy, changes in hormone levels and the physical effects of an enlarged uterus could cause new onset slow transit constipation or aggravate a pre-existing constipation. The management of slow transit constipation-induced ileus during pregnancy is a medical dilemma.

Patient concerns:

A 28-year-old pregnant woman presented to the emergency department with a 7-day history of worsening bloating and abdominal colic. The patient was in her third trimester (27 weeks). She had a 5-year history of constipation which had worsened with her pregnancy, and neither flatus nor stool could be passed.

Diagnosis:

Based on the constipation history and computed tomography, a slow transit constipation-induced ileus was confirmed.

Interventions:

As medications for the management of constipation and endoscopic efforts to remove the blockage were ineffective and the patient's symptoms worsened, Cesarean section and colectomy with ileorectal anastomosis were performed.

Outcomes:

After the procedure, the patient recovered and defecated well. At the 6-month follow-up, the patient reported that she defecated two to three times per day without difficulty.

Conclusion:

Pregnancy can worsen pre-existing constipation and cause ileus. In cases where drug treatment is unsuccessful, colectomy, and ileorectal anastomosis may be necessary.
Baduanjin exercise for cervical spondylotic radiculopathy
Authors: Dai Wenkang , Wang Xiongwei , Xie Rui , Zhuang Minghui , Chang Xiaojuan , Yang Guoqing , Yu Jie , Zhu Liguo
Published: May 2020

Background:

Cervical spondylotic radiculopathy (CSR) is one of the most common public health concerns in the world. Baduanjin is very widely and popularly practiced for the management of CSR. Therefore, we conducted a systematic review and meta-analysis to investigate the efficacy of Baduanjin exercise for patients with CSR.

Methods:

The PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials.gov, Cochrane Library, SinoMed, Chinese National Knowledge Infrastructure Database, Wan Fang database, and VIP databases were searched from inception to July 2019 to identify potentially eligible studies. The methodological quality of the included studies using the risk bias assessment tool of Cochrane. All statistical analysis are conducted with Revman 5.3.

Results:

This systematic review and meta-analysis will provide a synthesis of existing evidences for the treatment of Baduanjin on CSR.

Conclusion:

The conclusions of this study will provide evidence to evaluate the effectiveness of Baduanjin for CSR, which can further guide the promotion and clinical decisions.

PROSPERO registration number:

CRD42020149659
Clinical value of texture analysis in differentiation of urothelial carcinoma based on multiphase computed tomography images
Authors: Wang Zihua , He Yufang , Wang Nianhua , Zhang Ting , Wu Hongzhen , Jiang Xinqing , Mo Lei
Published: May 2020

Identification of histologic grading of urothelial carcinoma still depends on histopathologic examination. As an emerging and promising imaging technology, radiomic texture analysis is a noninvasive technique and has been studied to differentiate various tumors. This study explored the value of computed tomography (CT) texture analysis for the differentiation of low-grade urothelial carcinoma (LGUC), high-grade urothelial carcinoma (HGUC), and their invasive properties.

Radiologic data were analyzed retrospectively for 94 patients with pathologically proven urothelial carcinomas from November 2016 to April 2019. Pathologic examination demonstrated that tumors were: high grade in 43 cases, and low grade in 51 cases; and nonmuscle invasive (NMI) in 37 cases, and muscle invasive (MI) in 37 cases. Maximum tumor diameters on CT scan were manually outlined as regions of interest and 78 texture features were extracted automatically. Three-phasic CT images were used to measure texture parameters, which were compared with postoperative pathologic grading and invasive results. The independent sample t test or Mann–Whitney U test was used to compare differences in parameters. Receiver-operating characteristic curves for statistically significant parameters were used to confirm efficacy.

Of the 78 features extracted from each phase of CT images, 26 (33%), 20 (26%), and 22 (28%) texture parameters were significant (P < .05) for differentiating LGUC from HGUC, while 19 (24%), 16 (21%), and 30 (38%) were significant (P < .05) for differentiating NMI from MI urothelial carcinoma. Highest areas the under curve for differentiating grading and invasive properties were obtained by variance (0.761, P < .001) and correlation (0.798, P < .001) on venous-phase CT images.

Texture analysis has the potential to distinguish LGUC and HGUC, or NMI from MI urothelial carcinoma, before surgery.
Application of probiotics in adjuvant treatment of infant allergic rhinitis
Authors: Cao Xueqiu , Zhong Ping , Li Gang , Zhu Jiao , Zheng Yun
Published: May 2020

Background:

Several studies have suggested that intestinal flora may play an important role in allergic diseases. The purpose of this study was to investigate the effect of probiotics of Bifidobacterium triplex on the symptoms of allergic rhinitis (AR). The effects of this probiotic on the immune system have been reported in some studies, but most previous studies have been in animals.

Methods/Design:

60 infants and young children with AR were randomly divided into 2 groups: probiotics/placebo group. The main outcome was the use of a comprehensive symptom drug score to assess allergy symptoms. In addition, health-related quality of life was investigated (rhinitis quality of life questionnaire). Secondary outcomes included a visual analog scale of allergy burden and a second quality of life questionnaire. This report describes the study design of a randomized controlled trial.

Discussion:

The study design described a double-center, randomized, location at the Minda Hospital of Hubei Minzu University and West China Hospital of Sichuan University, which will be focused on the study about probiotics treatment and its effect on AR symptoms.

Trial registration:

It has been registered at http://www.chictr.org.cn/listbycreater.aspx (Identifier: ChiCTR2000031175), Registered March 22, 2020.
The correlation of patientsʼ anxiety after a liver or kidney transplantation with functional and self-reported work ability
Authors: Wesolowska-Gorniak Katarzyna , Wojtowicz Monika , Gierus Jacek , Czarkowska-Paczek Bozena
Published: May 2020

Organ transplantation has become the treatment of choice for end-stage organ failure, including renal and liver failure. The benefits of patient employment after transplantation are numerous, but factors determining the ability to work among these patients are not clearly defined. The growing interest in these factors has strong practical implications for organizations creating vocational rehabilitation programs. Given the interconnection between psychological and physical functioning in patients after transplantation, the present study examined the impact of anxiety on vocational rehabilitation and its relationship with functional tests. A total of 100 patients after liver or kidney transplantation underwent functional tests, including the 6-minute walking test and 30-second chair stand test (30”CST), and psychological tests, specifically the Inventory of Physical Activity Objectives, Work Ability Index, and State-Train Anxiety Inventory. Working ability was affected by psychological factors. State and trait anxiety exhibited inverse relationships with subjective readiness to occupational activity (P < .001, r = -.59 and P < .001, r = -.56, respectively). The level of anxiety was negatively related to the results of the 30”CST. State-Train Anxiety Inventory, State Anxiety subscale and State-Train Anxiety Inventory, State-Trait Anxiety subscale vs 30”CST: P < .001, r = -.43 P < .001, r = -.44). Thus, state and trait anxiety influence perceived work ability and partially functional status. These observations may indicate the potential benefits of including psychologists in interdisciplinary teams for physical and especially vocational rehabilitation of patients after liver or kidney transplantation.
Older Adult Suicides
Authors: Jones Andrea L. , Pastor Diane K.
Published: May 2020

Suicide among most age groups has been on the rise in the United States for the past 20 years. Suicide is currently the 10th leading cause of death in the United States, but suicide completion and suicide attempts may be underreported. Suicide is a very personal act often predicated on a sense of hopelessness and despair, but often prompted by very addressable factors such as pain and social isolation. This article will use a case narrative to illustrate life circumstances that may influence suicidal thinking. In addition, risk factors are addressed. Lastly, the article addresses some useful assessment tools to gauge suicide risk among older adult clients and provides resources for home care clinicians.
Utilization of a Visit-Based Sepsis Assessment to Prevent Hospital Readmissions
Authors: Yinger Kimberly , Bernas-Maley Melissa , Bhatia Vipul
Published: May 2020

Sepsis results in 270,000 deaths annually in the United States. Despite the current healthcare focus on sepsis, there exist few postacute best-practice standards to rapidly identify health changes in home healthcare patients to prevent and reduce hospital readmissions due to sepsis. We systematically examined whether an evidence-based process and intervention triggering home healthcare clinicians to activate a Positive Sepsis Assessment would reduce the likelihood that the patient would be readmitted to the acute care hospital. Over 24 months, we tracked the rate of sepsis readmissions to acute care hospitals through the initial phase of early recognition education; assessment, review, and revision of best-practice algorithms; standardized documentation; and proactive care management, in conjunction with the patient's primary care provider. During our review of the last 12 months of data on home care patients triggering the Positive Sepsis Assessment 130 patients were identified to have potential signs of sepsis. Ninety-seven of these patients received early medical intervention in place and were not readmitted to the hospital. Our findings suggest that a multidisciplinary home healthcare team utilizing standard sepsis education and sepsis algorithm on every patient during every visit can reduce and prevent readmissions.
When the Temporal Artery Biopsy is Negative
Authors: Ford Erika , Smith Jonathan H.
Published: May 2020

Introduction:

Older adults presenting with a new or changed headache pattern in the setting of a diagnosis of polymyalgia rheumatica (PMR) are at risk for incident giant cell arteritis. However, the differential diagnosis of headache has not been evaluated in patients with a negative temporal artery biopsy (TAB). Headache has not been described as a symptom of PMR.

Methods:

After prospectively identifying an individual felt to have headache attributed to PMR, we performed a chart review to identify additional cases. As a secondary outcome, we summarized alternative headache diagnoses in patients with PMR, headache and a negative TAB.

Results:

A 75-year-old woman presented with a subacute history of radiating cervical pain in the setting of a 3 month history of lower back stiffness at rest and fatigue. Clinical examination was suggestive of a cervicogenic headache. Following treatment with low-dose corticosteroid for PMR, headaches, cervical mobility and systemic findings resolved with treatment of PMR with low-dose corticosteroid. In our cohort of 36 patients, we identified a single additional patient meeting our study criteria for headache attributed to PMR. Three additional patients met all but 1 diagnostic criterion. The retrospective case was a 73-year-old woman with a subacute history of both morning-predominant headaches and muscle stiffness, diagnosed with PMR. Headaches remitted with low-dose corticosteroid and relapsed with corticosteroid taper.

Conclusions:

Headache attributed to PMR is a steroid-responsive syndrome which should be considered in an older adult presenting with features of PMR, when the TAB is negative. Diagnostic criteria for headache attributed to PMR are proposed.
Blepharospasm With Photophobia Secondary to Midbrain Tuberculoma and Thalamic Infarct
Authors: Chouksey Anjali , Pandey Sanjay
Published: May 2020

Introduction:

Blepharospasm is a type of focal dystonia and categorized into primary and secondary forms, based on whether or not a cause can be established. Secondary blepharospasm is uncommon and can be associated with underlying brain lesions. Photophobia is a prominent complaint in blepharospasm patients. We are reporting a case of secondary blepharospasm with photophobia in a patient who had underlying midbrain tuberculoma and thalamic infarcts. This type of presentation has not been reported to the best of our knowledge.

Case Report:

A 26-year-old man presented to us with the complaint of increased blinking and involuntary closure of both eyes for 1 year. He had a past history of tubercular meningitis 16 years back when he presented with bilateral ptosis, left up gaze palsy and right hemiparesis suggestive of Weber syndrome. His magnetic resonance images of the brain were suggestive of multiple intracranial tuberculomas, thalamic infarcts, and noncommunicating hydrocephalus. Following treatment he recovered significantly with no residual neurological deficit except mild bilateral ptosis. His recent magnetic resonance images of the brain was suggestive of calcified granuloma in the midbrain and chronic left thalamic lacunar infarcts. He was treated with injection Onabotulinum toxin and his symptoms improved significantly.

Conclusions:

Our patient had tuberculoma in the midbrain and chronic infarcts in the thalamus, and both lesions may cause blepharospasm and photophobia independently, so it is difficult to ascertain the causative lesion in our patient. However, it is possible that these heterogenous lesions are all part of a single functionally connected brain network and further studies are required to confirm this hypothesis.
Stroke-Associated Pneumonia
Authors: Patel Urvish K. , Kodumuri Nishanth , Dave Mihir , Lekshminarayanan Anusha , Khan Nashmia , Kavi Tapan , Kothari Ravish , Lunagariya Abhishek , Jani Vishal
Published: May 2020

Introduction:

Pneumonia is the most common complication after stroke, but our knowledge on risk factors and predictors of stroke-associated pneumonia (SAP) is limited. We sought to evaluate the predictors and outcomes of SAP among acute ischemic stroke (AIS) hospitalizations.

Methods:

This is a cross-sectional study of the Nationwide Inpatient Sample database from the year 2003 to 2014. We identified adult hospitalizations with AIS using International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) codes. The SAP was identified by the presence of a secondary diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia. Multivariable survey logistic regression models were utilized to evaluate the predictors of SAP.

Results:

Overall, 4,224,924 AIS hospitalizations were identified, of which 149,169 (3.53%) had SAP. The prevalence of SAP decreased from 3.72% in 2003 to 3.17% in 2014 (P<0.0001). Mortality [17.12% vs. 4.77%; adjusted odds ratio (aOR): 1.71;P<0.0001] and morbidity (22.53% vs. 3.28%; aOR: 1.86;P<0.0001) were markedly elevated in SAP group compare to non-SAP group. The significant risk factors of pneumonia among AIS hospitalization were nasogastric tube (aOR: 1.21;P=0.0179), noninvasive mechanical ventilation (aOR: 1.65;P<0.0001), invasive mechanical ventilation (aOR: 4.09;P<0.0001), length of stay between 1 to 2 weeks (aOR: 1.99;P<0.0001), >2 weeks (aOR: 3.90;P<0.0001), hemorrhagic conversion (aOR: 1.17;P=0.0002), and epilepsy (aOR: 1.09;P=0.0009). Other concurrent comorbidities which increased the risk of SAP among AIS patients were acquired immune deficiency syndrome (aOR: 1.88;P<0.0001), alcohol abuse (aOR: 1.60;P=0.0006), deficiency anemia (aOR: 1.26;P<0.0001), heart failure (aOR: 1.62;P<0.0001), pulmonary disease (aOR: 1.73;P<0.0001), diabetes (aOR: 1.29;P=0.0288), electrolyte disorders (aOR: 1.50;P<0.0001), paralysis (aOR: 1.22;P<0.0001), pulmonary circulation disorders (aOR: 1.22;P<0.0001), renal failure (aOR: 1.12;P<0.0001), coagulopathy (aOR: 1.13;P=0.0006), and weight loss (aOR: 1.39;P<0.0001).

Conclusion:

Our data underline the considerable epidemiological and prognostic impact of SAP in patients with AIS leading to higher mortality, morbidity, length of stay, and hospital cost despite advancements in care.
The Effect of Athletic Chest Protectors on the Performance of Manual and Mechanical CPR
Authors: Garg Nidhi , Brave Martina , Dym Akiva , Gupta Sanjey , Becker Lance B.
Published: May 2020

Objectives

Sudden cardiac arrest is a leading cause of death in athletes. Although athletes wear various athletic chest protectors (ACPs) to prevent commotio cordis (CC), cardiac arrest cases still occur. Although it is established that cardiopulmonary resuscitation (CPR) quality affects outcome, little research has evaluated the effect of ACPs on CPR compressions quality. This study aimed to observe whether: (1) ACPs impact depth, rate, and hand positioning of both bystander and LUCAS CPR. (2) LUCAS devices affect CPR performance compared with traditional compressions.

Methods

An observational, prospective, convenient sample of 26 emergency medicine residents performed CPR on a high-fidelity Laerdal mannequin, which recorded real-time performance data. Baseline CPR for 1- and 2-minute cycles, CPR on a mannequin wearing the ACP, and ACP removal time was recorded. LUCAS CPR performance was measured at baseline and over the ACP.

Results

Bystander CPR had a statistically significant difference in both hand placement and compression rate for baseline versus ACP compressions (85% vs 57%, P < 0.05; 138 vs 142, P < 0.05, respectively), but not in compression depth (51.08 vs 50.05 mm, P = 0.39). LUCAS CPR had no significant difference in CPR performance. Bystander versus LUCAS CPR had a significant difference in compression rate (138 vs 101, P < 0.01), but not in depth or hand placement.

Conclusions

Athletic chest protectors significantly impacted hand placement during bystander CPR, which may diminish CPR quality. Considering ACP removal required only 5.4 seconds, removing the ACP before standard CPR may improve quality.
End-Plate Disorders in Intensive Care Unit
Authors: Camdessanché Jean-Philippe
Published: May 2020

Even if nerves and muscles are the principal targets of intensive care unit-acquired weakness, the neuromuscular junction may be as well involved. In intensive care units, neuromuscular blocking agents are classically used, and side effects are possible. Sepsis, immobilization, and denervation which are common in intensive care units may be the cause of neuromuscular junction disorders and participate to the pathophysiology of weakness. We propose here a review of end-plate disorders in intensive care units to highlight their mechanisms and propose diagnosis tools.
Association of lipid peroxidation and interleukin-6 with carotid atherosclerosis in type 2 diabetes
Authors: Alharby Hesham , Abdelati Talaat , Rizk Mostafa , Youssef Eman , Moghazy Khaled , Gaber Noha , Yafei Saeed
Published: May 2020

Aim

Enhanced lipid peroxidation and elevated interleukin-6 levels are common in type 2 diabetes mellitus patients. Atherosclerotic vascular complications greatly contribute to morbidity and mortality in diabetes. The aim of this study was to assess the relation of lipid peroxidation and interleukin-6 with carotid atherosclerosis in type 2 diabetes mellitus.

Methods

This cross-sectional study included 90 type 2 diabetes mellitus male patients with age ≥ 40 years and 30 healthy male subjects matched for age. All of them were subjected to measuring of 8-iso prostaglandin F2α as a marker of lipid peroxidation, interleukin-6 and carotid intima media thickness as a marker of carotid atherosclerosis.

Results

Both 8-iso prostaglandin F2α and interleukin-6 were found to have significant positive correlation with carotid intima media thickness (P < 0.001) and both were found to be significant predictors of the presence of subclinical carotid atherosclerosis in multiple regression analysis.

Conclusion

Lipid peroxidation and interleukin-6 may play an important role in atherogenesis in type 2 diabetes mellitus and limiting their effects may reduce atherosclerotic vascular complications in type 2 diabetes mellitus.
The comparison of the relationships about the presence of branch retinal vein occlusion and endothelial functions between diabetic and non-diabetic patients
Authors: Demir Vahit , Dogru Mehmet Tolga , Onaran Zafer , Kandemir Huseyin , Alp Caglar
Published: May 2020

Objectives

The aim of this study was to investigate the endothelial functions in both patients with diabetics and non-diabetics with branch retinal vein occlusion by using pulse wave analysis and flow-mediated dilatation methods.

Patients and methods

This cross-sectional study included a total of 136 participants (47 diabetic patients with branch retinal vein occlusion, 43 non-diabetic patients with branch retinal vein occlusion, and 46 otherwise healthy subjects). Evaluation of endothelial functions was performed by flow-mediated dilatation and pulse wave analysis methods. Stiffness index, reflection index (RI), and pulse propagation time were calculated.

Results

The mean stiffness index and RI were significantly higher in the diabetic branch retinal vein occlusion group compared with the non-diabetic branch retinal vein occlusion and the healthy controls (for stiffness index: 11.5 ± 2.8 vs. 10.1 ± 2.5 and 8.3 ± 2.0, P < 0.001; and for RI: 75.1 ± 11.7 vs. 65.4 ± 8.4 and 60.2 ± 18.8, P < 0.001, respectively), whereas the pulse propagation time was significantly lower in the diabetic group (156.4 ± 32.3 vs. 174.4 ± 46.5 and 205.0 ± 58.5, P < 0.001, respectively). There was a significant negative correlation between visual acuity and stiffness index (r = −0.512, P < 0.001). Besides, there was also a significant positive correlation between visual acuity and pulse propagation time (r = 0.398, P < 0.001).

Conclusion

This study demonstrated that the stiffness index and RI values were higher in patients with branch retinal vein occlusion compared to the healthy subjects.
Ten tips for promoting your research
Authors: Hardman Timothy C. , Krentz Andrew J. , Wierzbicki Anthony S.
Published: May 2020

Publishing the results of scientific research is more than a personal choice; it is an ethical and increasingly regulatory obligation. It is generally accepted that top-ranking journals attract wider audiences than specialist publications and scientists have long recognised that the importance of targeting so-called high impact journal in getting their work noticed. However, gaining access to top-flight journals is difficult and a broader exposure is not necessarily guaranteed. Huge competition exists for attention within the scientific literature. Traditionally, scientists have viewed promoting their own research as somewhat self-serving and gauche, preferring its value to speak (passively) for itself. However, times have changed. Researchers can now be divided into two camps: those who see publication of their research as the final step in the process and those who see it as the first step in sharing their findings with the wider world. We summarize here 10 considerations for peri-publication activities that, when used in the right measure and appropriately to the work involved should aid those looking to increase the discoverability, readership and impact of their scientific research. The internet has transformed scientific communication. If you ignore this development, it is possible that your research will not get the recognition it deserves. You need to identify the specific issues to focus on (scope) and how much effort (resource) you are prepared to commit.

Video abstract: http://links.lww.com/CAEN/A22.
Using Supervised Machine Learning and Empirical Bayesian Kriging to reveal Correlates and Patterns of COVID-19 Disease outbreak in sub-Saharan Africa: Exploratory Data Analysis
Authors: Onovo Amobi Andrew , Atobatele Akinyemi , Kalaiwo Abiye , Obanubi Christopher , James Ezekiel , Gado Pamela , Odezugo Gertrude , Ogundehin Dolapo , Magaji Doreen , Russell Michele
Published: May 2020

Introduction

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan1,2, China, and has subsequently spread worldwide. Knowledge of coronavirus-related risk factors can help countries build more systematic and successful responses to COVID-19 disease outbreak. Here we used Supervised Machine Learning and Empirical Bayesian Kriging (EBK) techniques to reveal correlates and patterns of COVID-19 Disease outbreak in sub-Saharan Africa (SSA).

Methods

We analyzed time series aggregate data compiled by Johns Hopkins University on the outbreak of COVID-19 disease across SSA. COVID-19 data was merged with additional data on socio-demographic and health indicator survey data for 39 of SSA’s 48 countries that reported confirmed cases and deaths from coronavirus between February 28, 2020 through March 26, 2020. We used supervised machine learning algorithm, Lasso for variable selection and statistical inference. EBK was used to also create a raster estimating the spatial distribution of COVID-19 disease outbreak.

Results

The lasso Cross-fit partialing out predictive model ascertained seven variables significantly associated with the risk of coronavirus infection (i.e. new HIV infections among pediatric, adolescent, and middle-aged adult PLHIV, time (days), pneumococcal conjugate-based vaccine, incidence of malaria and diarrhea treatment). Our study indicates, the doubling time in new coronavirus cases was 3 days. The steady three-day decrease in coronavirus outbreak rate of change (ROC) from 37% on March 23, 2020 to 23% on March 26, 2020 indicates the positive impact of countries’ steps to stymie the outbreak. The interpolated maps show that coronavirus is rising every day and appears to be severely confined in South Africa. In the West African region (i.e. Burkina Faso, Ghana, Senegal, Cote d’Iviore, Cameroon, and Nigeria), we predict that new cases and deaths from the virus are most likely to increase.

Interpretation

Integrated and efficiently delivered interventions to reduce HIV, pneumonia, malaria and diarrhea, are essential to accelerating global health efforts. Scaling up screening and increasing COVID-19 testing capacity across SSA countries can help provide better understanding on how the pandemic is progressing and possibly ensure a sustained decline in the ROC of coronavirus outbreak.

Funding

Authors were wholly responsible for the costs of data collation and analysis.
When the storm is the strongest: Healthcare staff’s health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19
Authors: Zhang Stephen X. , Liu Jing , Jahanshahi Asghar Afshar , Nawaser Khaled , Li Jizhen , Alimoradi Hadiseh
Published: May 2020

This study reports the physical health, mental health, anxiety, depression, distress, and job satisfaction of healthcare staff in Iran when the country faced its highest number of total active COVID-19 cases. In a sample of 304 healthcare staff (doctors, nurses, radiologists, technicians, etc.), we found a sizable portion reached the cutoff levels of disorders in anxiety (28.0%), depression (30.6%), and distress (20.1%). Age, gender, education, access to PPE (personal protective equipment), healthcare institutions (public vs. private), and individual status of COVID-19 infection each predicted some but not all the outcome variables of SF-12, PHQ-4, K6, and job satisfaction. The healthcare workers varied greatly in their access to PPE and in their status of COVID-19 infection: negative (69.7%), unsure (28.0%), and positive (2.3%). The predictors were also different from those identified in previous studies of healthcare staff during the COVID-19 crisis in China. This study helps to identify the healthcare staff in need to enable more targeted help as healthcare staff in many countries are facing peaks in their COVID-19 cases.
SARS-CoV-2 receptor mutation in Egyptian population
Authors: Hafez Mohamed M , Hassan Zeinab K , Bahnasy Abeer A. , Ahmed Ola S. , Abouelhoda Mohamed , Zekri Abdel-Rahman N.
Published: May 2020

The Coronavirus disease 2019 (COVID-19) is a respiratory tract infectious disease caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 triggers severe pneumonia leading to acute respiratory distress syndrome and death in severe cases. According to WHO reported, Egypt is among the countries with low confirmed SARS CoV2 infected symptomatic cases and death. We postulate that one of the reasons for this may be due mutations in the viral receptor. Therefore this study was conducted to confirm or reject this postulation.
Mathematical Model to Study Early COVID-19 Transmission Dynamics in Sri Lanka
Authors: Perera Sanjeewa Nishantha , Ganegoda Naleen C , Siriwardhana Dhammika Deepani , Weerasinghe Manuj C
Published: May 2020

Background

World Health Organization declared COVID-19 as a pandemic on 11th March. Sri Lanka is currently experiencing a cluster epidemic with a specific group of overseas returnees and their contacts. The objective of this study was to develop a mathematical model to predict the epidemic in Sri Lanka incorporating measures taken for social distancing and prevention of social gatherings.

Methods

A hybrid model incorporating both exponential and polynomial features was developed and parameters were estimated. The developed model was validated using the datasets of three reference countries. Finally, the model was applied to the Sri Lankan data to simulate the epidemic behaviour. Additional features were incorporated to the model to examine the effects of current control measures.

Findings

Sri Lanka will have a peak of 177 COVID-19 active cases at the end of second incubation period from the index case of our projection, if the same trend continues. At 10% risk, we project a peak of 263 COVID-19 active cases at the end of third incubation period, and a peak of 353 at the end of fourth incubation period. Should the risk level reach 20%, the peak will be above 1000 active cases after 90 days. Simulations incorporating control measures predict that, deviation from the control measures currently in place could trigger exponential behaviour of the epidemic.

Interpretation

The hybrid model combining exponential and polynomial functions showed promising results to predict COVID-19 epidemic. Projections indicate that any early relaxation of control measures is not advisable. This methodological approach can be replicated in other settings at the initial stages of the epidemic.
Comparison of the Clinical Implications among Two Different Nutritional Indices in Hospitalized Patients with COVID-19
Authors: Du Xuebei , Liu Yuwei , Chen Jing , Peng Li , Jin Yalei , Cheng Zhenshun , Wang Harry H.X. , Luo Mingqi , Chen Ling , Zhao Yan
Published: May 2020

Background

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease.It was first reported in Wuhan, China, and then broke out on a large scale around the world.This study aimed to assess the clinical significance of two different nutritional indices in 245 patients with COVID-19.

Methods

In this retrospective single-center study, we finally included 245 consecutive patients who confirmed COVID-19 in Wuhan University Zhongnan Hospital from January 1 to February 29. Cases were classified as either discharged or dead. Demographic, clinical and laboratory datas were registered, two different nutritional indices were calculated: (i)the Controlling nutritional status (CONUT) score; (ii) prognostic nutritional index (PNI). We used univariate and multivariate logistic regression analysis to explore the relationship between nutritional indices and hospital death.

Results

212 of them were discharged and 33 of them died. In-hospital mortality was signifcantly higher in the severe group of PNI than in the moderate and normal groups. It was also significantly worse in the severe-CONUT group than in the moderate-, mild-, and normal-CONUT groups. Multivariate logistic regression analysis showed the CONUT score (odds ratio3.371,95%CI (1.124–10.106), p = 0.030) and PNI(odds ratio 0.721,95% CI (0.581–0.896), P=0.003) were independent predictors of all-cause death at an early stage; Multivariate logistic regression analysis also showed that the severe group of PNI was the independent risk predictor of in-hospital death(odds ratio 24.225, 95% CI(2.147–273.327), p=0.010).The CONUT score cutoff value was 5.5 (56.00 and 80.81%; AUC 0.753; 95% CI (0.644–0.862); respectively). The PNI cutoff value was 40.58 (81.80 and 66.20%; AUC 0.778; 95% CI (0.686–0.809); respectively). We use PNI and the COUNT score to assess malnutrition, which can have a prognosis effect of COVID-19patients.

Conclusion

The CONUT score and PNI could be a reliable prognostic marker of all-cause deathin patients with COVID-19.
COVID-19 and Inflammatory Bowel Diseases: risk assessment, shared molecular pathways and therapeutic challenges
Authors: Popa Iolanda Valentina , Diculescu Mircea , Mihai Cătălina , Cijevschi-Prelipcean Cristina , Burlacu Alexandru
Published: May 2020

Background

The novel coronavirus SARS-CoV-2 causing COVID-19 disease is yielding a global outbreak with serious threats to public health. In this paper, we aimed to review the current knowledge about COVID-19 infectious risk status in inflammatory bowel disease (IBD) patients requiring immunosuppressive medication. Also, we focused on several molecular insights that could explain why IBD patients appear to not have higher risks of infection and worse outcome in COVID-19 than the general population, in attempt to provide scientific support for safer decisions in IBD patient care.

Methods

PubMed electronic database was interogated for relevant articles involving data about common molecular pathways and shared treatment strategies between SARS-CoV-2, SARS-CoV-1, MERS-CoV and inflammatory bowel diseases. In addition, Neural Covidex, an artificial intelligence tool, was used to answer queries about pathogenic coronaviruses and possible IBD interactions using the COVID-19 Open Research Dataset (CORD-19).

Discussions

Few molecular and therapeutic interactions between IBD and pathogenic coronaviruses were explored. First, we showed how the activity of soluble angiotensin-converting enzyme 2, CD209L alternate receptor and phosphorylated α subunit of eukaryotic translation initiation factor 2 might exert protective impact in IBD in case of coronavirus infection. Second, IBD medication was discussed in the context of possible beneficial effects on COVID-19 pathogeny including “cytokine storm” prevention and treatment, immunomodulation, interferon signaling blocking, viral endocytosis inhibition.

Conclusions

Using current understanding of SARS-CoV-2 as well as other pathogenic coronaviruses immunopathology, we showed why IBD patients should not be considered at an increased risk of infection or more severe outcomes. Whether our findings are entirely applicable to the pathogenesis, disease susceptibility and treatment management of SARS-CoV-2 infection in IBD must be further explored.
Tuberculosis and COVID-19 in 2020: lessons from the past viral outbreaks and possible future outcomes
Authors: Crisan-Dabija Radu , Grigorescu Cristina , Pavel Cristina-Alice , Artene Bogdan , Popa Iolanda Valentina , Cernomaz Andrei , Burlacu Alexandru
Published: May 2020

Background

The threat of contagious infectious diseases is constantly evolving, as demographic explosion, travel globalization and changes in human lifestyle increase the risk of spreading pathogens, leading to accelerated changes in disease landscape. Of particular interest is the aftermath of superimposing viral epidemics (especially SARS-CoV-2) over long-standing diseases, such as tuberculosis (TB), which remains a significant disease for public health worldwide and especially in emerging economies.

Methods and Results

PubMed electronic database was requested for relevant articles linking TB, influenza and SARS-CoV viruses and subsequently assessed eligibility according to inclusion criteria. Using a data mining approach, we also queried the COVID-19 Open Research Dataset (CORD-19). We aimed to answer the following questions: What can be learned from other coronavirus outbreaks (with a focus on TB patients)? Is coinfection (TB and SARS-CoV-2) more severe? Is there a vaccine for SARS-CoV-2? How does the TB vaccine affect COVID19? How does one diagnosis affect the other?

Discussions

Few essential elements about TB and SARS-CoV coinfections were discussed. First, lessons from the past outbreaks (other coronaviruses), as well as influenza pandemic / seasonal outbreaks have taught the importance of infection control to avoid the severe impact on TB patients. Second, although challenging due to data scarcity, investigating the pathological pathways linking TB and SARS-CoV-2 leads to the idea that their coexistence might yield a more severe clinical evolution. Finally, we addressed the issues of vaccination and diagnostic reliability in the context of coinfection.

Conclusions

Because viral respiratory infections and TB impede the host’s immune responses, it can be assumed that their harmful synergism may contribute to more severe clinical evolution. Despite the rapidly growing number of cases, the data needed to predict the impact of the COVID-19 pandemic on patients with latent TB and TB sequelae still lies ahead.
A comparison of health care worker-collected foam and polyester nasal swabs in convalescent COVID-19 patients
Authors: Hart Brian , Tu Yuan-Po , Jennings Rachel , Verma Prateek , Padgett Leah R , Rains Douglas , Vojta Deneen , Berke Ethan M
Published: May 2020

Background

The exponential growth of COVID-19 cases and testing has created supply shortages at various points in the testing workflow. As of April 15, 2020 FDA recommendations only allowed for the use of nasopharyngeal, flocked mid turbinate, or foam nasal swabs, all of which are in very low supply. Polyester swabs are more readily available and mass producible. We compare the performance of polyester and foam swabs stored in different transport media.

Methods

Both polyester and foam nasal swabs were collected from convalescent COVID-19 patients at a single visit. Using the foam nasal swabs as the comparator, sensitivity of the polyester swabs in each media were calculated, three by three tables were constructed to measure concordance, and cycle threshold (Ct) values were compared.

Findings

126 visits had polyester and foam swabs stored in viral transport media (VTM), 51 had polyester and foam swabs stored in saline, and 63 had a foam swab in VTM and a polyester swab stored in a dry tube. Using nasal foam swabs as a comparator, polyester nasal swabs had a sensitivity of 86·5% when both samples were stored in VTM, 86·7% when both samples were stored in saline, and 72·4% when the polyester swab was stored dry and the foam swab was stored in VTM. Polyester and foam Ct values from the same visit were correlated, but polyester swabs showed decreased performance for cases with a viral load near the detection threshold and higher Ct values on average.

Interpretation

Polyester nasal swabs showed a reduction in performance from foam nasal swabs, but may still provide a viable sample collection method given the current supply shortages and public health emergency.

Funding

Laboratory testing was conducted with financial support from Thermo Fisher Scientific.
Unannotated small RNA clusters in circulating extracellular vesicles detect early stage liver cancer
Authors: von Felden Johann , Garcia-Lezana Teresa , Dogra Navneet , Kozlova Edgar , Ahsen Mehmet Eren , Craig Amanda J. , Gifford Stacey , Wunsch Benjamin , Smith Joshua T. , Kim Sungcheol , Diaz Jennifer E. L. , Chen Xintong , Labgaa Ismail , Haber Philipp K. , Olsen Reena , Han Dan , Restrepo Paula , D’Avola Delia , Hernandez-Meza Gabriela , Allette Kimaada , Sebra Robert , Saberi Behnam , Tabrizian Parissa , Asgharpour Amon , Dieterich Douglas , Llovet Josep M , Cordon-Cardo Carlos , Tewari Ash , Schwartz Myron , Stolovitzky Gustavo , Losic Bojan , Villanueva Augusto
Published: May 2020

Background

Hepatocellular carcinoma (HCC) is among the deadliest malignancies and surveillance tools for early detection are suboptimal. Extracellular vesicles (EVs) have gained increasing scientific interest due to their involvement in tumor initiation and metastasis, however, most extracellular RNA (exRNA) biomarker studies are limited to annotated genomic regions.

Methods

EVs were isolated with ultracentrifugation and nanoDLD and quality assessed by electron microscopy, immunoblotting, nanoparticle tracking, and deconvolution analysis. We performed genome-wide small exRNA sequencing, including unannotated transcripts. We identified small RNA clusters (smRCs) and delineated their key genomic features across biospecimens (blood, urine, tissue) and EV isolation techniques. A 3-smRC signature for early HCC detection was trained and validated in two independent cohorts.

Results

EV-derived smRCs were dominated by uncharacterized, unannotated small RNA and uniformly tiled across the genome with a consensus sequence of 20bp. A 3-smRC signature was significantly overexpressed in circulating EVs of HCC patients compared to controls at risk or patients with non-HCC malignancies (p<0.01, n=157). An independent validation in a phase 2 biomarker study revealed 86% sensitivity and 91% specificity for the detection of early HCC from controls at risk (i.e. cirrhosis or chronic liver disease, n=209) (positive predictive value (PPV): 89%, area under the ROC curve [AUC]: 0.87). The 3-smRC signature was independent of alpha-fetoprotein (p<0.0001) and a composite model yielded an increased AUC of 0.93 (sensitivity: 85%, specificity: 94%, PPV: 95%).

Conclusion

An exRNA-based 3-smRC signature from plasma detects early stage HCC, which directly leads to the prospect of a minimally-invasive, blood-only, operator-independent surveillance biomarker.

One sentence summary

We employ a novel, data-driven approach to identify and characterize small RNA clusters from unannotated loci in extracellular vesicle-derived RNA across different cancer types, isolation techniques, and biofluids, facilitating discovery of a robust biomarker for detection of early stage liver cancer.