bluuebunny/crossref_metadata_2025 huggingface dataset:
Resolving the outer ring of HD 38206 using ALMA and constraining limits on planets in the system
Authors: Booth Mark , Schulz Michael , Krivov Alexander V , Marino Sebastián , Pearce Tim D , Launhardt Ralf
Published: October 2020

HD 38206 is an A0V star in the Columba association, hosting a debris disc first discovered by IRAS. Further observations by Spitzer and Herschel showed that the disc has two components, likely analogous to the asteroid and Kuiper belts of the Solar system. The young age of this star makes it a prime target for direct imaging planet searches. Possible planets in the system can be constrained using the debris disc. Here, we present the first ALMA observations of the system’s Kuiper belt and fit them using a forward modelling MCMC approach. We detect an extended disc of dust peaking at around 180 au with a width of 140 au. The disc is close to edge on and shows tentative signs of an asymmetry best fit by an eccentricity of $0.25^{+0.10}_{-0.09}$. We use the fitted parameters to determine limits on the masses of planets interior to the cold belt. We determine that a minimum of four planets are required, each with a minimum mass of 0.64 MJ, in order to clear the gap between the asteroid and Kuiper belts of the system. If we make the assumption that the outermost planet is responsible for the stirring of the disc, the location of its inner edge and the eccentricity of the disc, then we can more tightly predict its eccentricity, mass, and semimajor axis to be $e_{\rm {p}}=0.34^{+0.20}_{-0.13}$, $m_{\rm {p}}=0.7^{+0.5}_{-0.3}\, \rm {\it M}_{\rm {J}}$, and $a_{\rm {p}}=76^{+12}_{-13}\, \rm {au}$.
canSAR: update to the cancer translational research and drug discovery knowledgebase
Authors: Mitsopoulos Costas , Di Micco Patrizio , Fernandez Eloy Villasclaras , Dolciami Daniela , Holt Esty , Mica Ioan L , Coker Elizabeth A , Tym Joseph E , Campbell James , Che Ka Hing , Ozer Bugra , Kannas Christos , Antolin Albert A , Workman Paul , Al-Lazikani Bissan
Published: October 2020

canSAR (http://cansar.icr.ac.uk) is the largest, public, freely available, integrative translational research and drug discovery knowledgebase for oncology. canSAR integrates vast multidisciplinary data from across genomic, protein, pharmacological, drug and chemical data with structural biology, protein networks and more. It also provides unique data, curation and annotation and crucially, AI-informed target assessment for drug discovery. canSAR is widely used internationally by academia and industry. Here we describe significant developments and enhancements to the data, web interface and infrastructure of canSAR in the form of the new implementation of the system: canSARblack. We demonstrate new functionality in aiding translation hypothesis generation and experimental design, and show how canSAR can be adapted and utilised outside oncology.
CONQUER: an interactive toolbox to understand functional consequences of GWAS hits
Authors: Bouland Gerard A , Beulens Joline W J , Nap Joey , van der Slik Arno R , Zaldumbide Arnaud , ’t Hart Leen M , Slieker Roderick C
Published: October 2020

Numerous large genome-wide association studies have been performed to understand the influence of genetics on traits. Many identified risk loci are in non-coding and intergenic regions, which complicates understanding how genes and their downstream pathways are influenced. An integrative data approach is required to understand the mechanism and consequences of identified risk loci. Here, we developed the R-package CONQUER. Data for SNPs of interest are acquired from static- and dynamic repositories (build GRCh38/hg38), including GTExPortal, Epigenomics Project, 4D genome database and genome browsers. All visualizations are fully interactive so that the user can immediately access the underlying data. CONQUER is a user-friendly tool to perform an integrative approach on multiple SNPs where risk loci are not seen as individual risk factors but rather as a network of risk factors.
aliFreeFoldMulti: alignment-free method to predict secondary structures of multiple RNA homologs
Authors: Bossanyi Marc-André , Carpentier Valentin , Glouzon Jean-Pierre S , Ouangraoua Aïda , Anselmetti Yoann
Published: October 2020

Predicting RNA structure is crucial for understanding RNA’s mechanism of action. Comparative approaches for the prediction of RNA structures can be classified into four main strategies. The three first—align-and-fold, align-then-fold and fold-then-align—exploit multiple sequence alignments to improve the accuracy of conserved RNA-structure prediction. Align-and-fold methods perform generally better, but are also typically slower than the other alignment-based methods. The fourth strategy—alignment-free—consists in predicting the conserved RNA structure without relying on sequence alignment. This strategy has the advantage of being the faster, while predicting accurate structures through the use of latent representations of the candidate structures for each sequence. This paper presents aliFreeFoldMulti, an extension of the aliFreeFold algorithm. This algorithm predicts a representative secondary structure of multiple RNA homologs by using a vector representation of their suboptimal structures. aliFreeFoldMulti improves on aliFreeFold by additionally computing the conserved structure for each sequence. aliFreeFoldMulti is assessed by comparing its prediction performance and time efficiency with a set of leading RNA-structure prediction methods. aliFreeFoldMulti has the lowest computing times and the highest maximum accuracy scores. It achieves comparable average structure prediction accuracy as other methods, except TurboFoldII which is the best in terms of average accuracy but with the highest computing times. We present aliFreeFoldMulti as an illustration of the potential of alignment-free approaches to provide fast and accurate RNA-structure prediction methods.
Second series by the Italian Association of Pediatric Hematology and Oncology of children and adolescents with intracranial ependymoma: an integrated molecular and clinical characterization with a long-term follow-up
Authors: Massimino Maura , Barretta Francesco , Modena Piergiorgio , Witt Hendrik , Minasi Simone , Pfister Stefan M , Pajtler Kristian W , Antonelli Manila , Gandola Lorenza , Luisa Garrè Maria , Bertin Daniele , Mastronuzzi Angela , Mascarin Maurizio , Quaglietta Lucia , Viscardi Elisabetta , Sardi Iacopo , Ruggiero Antonio , Pollo Bianca , Buccoliero Annamaria , Boschetti Luna , Schiavello Elisabetta , Chiapparini Luisa , Erbetta Alessandra , Morra Isabella , Gessi Marco , Donofrio Vittoria , Patriarca Carlo , Giangaspero Felice , Johann Pascal , Buttarelli Francesca Romana
Published: October 2020

Background

A prospective 2002–2014 study stratified 160 patients by resection extent and histological grade, reporting results in 2016. We re-analyzed the series after a median of 119 months, adding retrospectively patients’ molecular features.

Methods

Follow-up of all patients was updated. DNA copy number analysis and gene-fusion detection could be completed for 94/160 patients, methylation classification for 68.

Results

Progression-free survival (PFS) and overall survival (OS) at 5/10 years were 66/58%, and 80/73%. Ten patients had late relapses (range 66–126 mo), surviving after relapse no longer than those relapsing earlier (0–5 y). On multivariable analysis a better PFS was associated with grade II tumor and complete surgery at diagnosis and/or at radiotherapy; female sex and complete resection showed a positive association with OS. Posterior fossa (PF) tumors scoring ≥0.80 on DNA methylation analysis were classified as PFA (n = 41) and PFB (n = 9). PFB patients had better PFS and OS. Eighteen/32 supratentorial tumors were classified as RELA, and 3 as other molecular entities (anaplastic PXA, LGG MYB, HGNET). RELA had no prognostic impact. Patients with 1q gain or cyclin-dependent kinase inhibitor 2A (CDKN2A) loss had worse outcomes, included significantly more patients >3 years old (P = 0.050) and cases of dissemination at relapse (P = 0.007).

Conclusions

Previously described prognostic factors were confirmed at 10-year follow-up. Late relapses occurred in 6.2% of patients. Specific molecular features may affect outcome: PFB patients had a very good prognosis; 1q gain and CDKN2A loss were associated with dissemination. To draw reliable conclusions, modern ependymoma trials need to combine diagnostics with molecular risk stratification and long-term follow-up.
EARLY RESPONSE TO DEHYDRATION 7 Remodels Cell Membrane Lipid Composition during Cold Stress in Arabidopsis
Authors: Barajas-Lopez Juan de Dios , Tiwari Arjun , Zarza Xavier , Shaw Molly W , Pascual Jes�s , Punkkinen Matleena , Bakowska Joanna C , Munnik Teun , Fujii Hiroaki
Published: October 2020

Plants adjust to unfavorable conditions by altering physiological activities, such as gene expression. Although previous studies have identified multiple stress-induced genes, the function of many genes during the stress responses remains unclear. Expression of ERD7 (EARLY RESPONSE TO DEHYDRATION 7) is induced in response to dehydration. Here, we show that ERD7 plays essential roles in both plant stress responses and development. In Arabidopsis, ERD7 protein accumulated under various stress conditions, including exposure to low temperature. A triple mutant of Arabidopsis lacking ERD7 and two closely related homologs had an embryonic lethal phenotype, whereas a mutant lacking the two homologs and one ERD7 allele had relatively round leaves, indicating that the ERD7 gene family has essential roles in development. Moreover, the importance of the ERD7 family in stress responses was evidenced by the susceptibility of the mutant lines to cold stress. ERD7 protein was found to bind to several, but not all, negatively charged phospholipids and was associated with membranes. Lipid components and cold-induced reduction in PIP2 in the mutant line were altered relative to wild type. Furthermore, membranes from the mutant line had reduced fluidity. Taken together, ERD7 and its homologs are important for plant stress responses and development and associated with the modification in membrane lipid composition.
Changing landscapes of death and burial practices: public health response in time of COVID-19 pandemic
Authors: Sarmiento Philip Joseph D
Published: October 2020

In a recent correspondence published in this journal, the author calls for spiritual interventions for the living and the dead that be considered by the medical community especially in the time of COVID-19. This paper further elaborates on the need to consider the death and burial practices of bereaved families of patients who died of COVID-19 with strict observance of health protocols. Death and burial practices are significant moments in finding meaning for bereaved families in accepting the demise of their loved ones during this pandemic.
Intellectual Property Protection and Financial Markets: Patenting versus Secrecy*
Authors: Dass Nishant , Nanda Vikram , Park Haemin Dennis , Xiao Steven Chong
Published: October 2020

Firms rely on patenting and trade secrecy to protect their intellectual property. We study how changes in the trade-off between patenting and secrecy affect firms’ stock liquidity and financing outcomes. We show that an international trade agreement (TRIPS) that strengthened patent protection led to a 10.2% increase in patenting, accompanied by a 14.0%–27.1% improvement in stock liquidity for firms in patent-reliant industries. This in turn allows the affected firms to increase equity financing by 1.9% and reduce leverage by 5.9%. Our results suggest that policies that promote use of patenting over secrecy can reduce informational frictions in equity markets.
Black Healers, Surgeons and ‘Witches’: Medicine, Mobility and Knowledge Exchange in Swedish St Barthélemy 1785–1815
Authors: Thomasson Fredrik
Published: October 2020

When Swedish civil servants took possession of the Caribbean island of St Barthélemy in 1785, they discovered a complex medical landscape in which Black healers played important roles. They competed with white physicians for patients and formed an itinerant community—both voluntary and forced in nature—which travelled throughout the archipelago exchanging remedies and practices. The healers’ work was not associated to revolt and rebellion as in many other Caribbean territories and the Swedish court of law treated them with less cruelty than in many other colonies. The healers’ activities cannot be simply reduced to acts of resistance to slavery; many of them gained the trust of large parts of both Black and white communities. Their interactions with people on the surrounding islands show how Caribbean colonial historiography gains from a wider geographical contextualisation, allowing a better understanding of the Black population’s role in healing and medicine.
Age-associated trends of vulvar cancer in the US
Authors: Khadraoui Hanaa , Thappa Sarah , Smith Marianne , Davidov Adi , Castellanos Mario R.
Published: October 2020

Objective:

Medical societies have over the years moved away from recommending routine pelvic examinations in older, asymptomatic women above age 65. Consequently, vulvar examination is a largely neglected component of the physical examination, unless sent to a specialist for gynecological evaluation. In recognition of these recommendations, we analyzed US trends in vulvar cancer incidence, age, and stage at diagnosis, survival, and association with human papillomavirus (HPV).

Methods:

Cases of vulvar and cervical cancer from 1992 to 2014 were extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results and Centers for Disease Control's data on age at diagnosis, stage of disease, and HPV-association were analyzed and compared. Incidence and mortality rates were extracted and calculated.

Results:

From 1992-2014, there was a 14.3% increase in vulvar cancer rates. The absolute average incidence rate was 2.25, with HPV still being seen in vulvar carcinomas in women 65 years and above. Cervical cancer mortality rates declined by 34.2%, while vulvar cancer death rates were unchanged. We show increased intervals for cervical cancer screening is associated with later stage vulvar cancer detection. The proportion of vulvar cancer cases diagnosed in women age <50 steadily decreased, from 42.05% of cases in 1992-1996 to 19.75% of total cases in 2012-2015. Meanwhile, vulvar cancer cases diagnosed in women > 65 yo increased from 36.62% of cases in 1992-1996 to 49.82% of cases in 2012-2015.

Conclusion:

The incidence of vulvar cancer increases with age, with the median age of diagnosis 67 years, with HPV (+) tumors occurring into 70's and 80's. Though medical societies do not routinely recommend an external genital examination in women 65 years and above, we show this is a missed opportunity to improve cancer outcomes in some older females.

Video Summary:

http://links.lww.com/MENO/A678.
Altered trigeminal pain processing on brainstem level in persistent idiopathic facial pain
Authors: Ziegeler Christian , Schulte Laura H. , May Arne
Published: October 2020

Persistent idiopathic facial pain (PIFP) is a poorly understood chronic pain syndrome of the face, formerly known as atypical facial pain. It is characterized by a constant painful sensation without neurological abnormalities and without clinically objectifiable cause. Similarities to neuropathic pain conditions have been discussed and are currently thought to be relevant for the pathophysiology of this disease. In this study, we aim to characterize the trigeminal pain processing in PIFP using functional magnetic resonance imaging of the brainstem. Twenty-five patients suffering from PIFP and 25 healthy controls underwent a standardized and well-established paradigm of painful stimulation of the trigeminal nerve using gaseous ammonia. Functional images were acquired within a 3T magnetic resonance imaging scanner using an optimized protocol for high-resolution echo planar brainstem imaging. Patients with PIFP show exclusively a stronger activation to painful stimulation in the spinal trigeminal nucleus when contrasted against healthy controls. Our data suggest that abnormal central pain processing plays a role in the pathophysiology of PIFP. An integration of these findings into neuropathic pain models might help to gain a better general understanding of the pathophysiology of PIFP.
Evidence-based Classification in Track Athletics for Athletes with a Vision Impairment: A Delphi Study
Authors: Allen Peter M. , Dolan Rebecca , Croxall Helen , Ravensbergen Rianne H. J. C. , Brooks Ashley , Zenk Franziska , Mann David L.
Published: October 2020

SIGNIFICANCE

The Delphi analysis presented here highlights the need for a sport-specific evidence-based classification system for track athletics for athletes with a vision impairment (VI). This system may differ for different race distances. Further research is required to develop a useful test battery of vision tests for classification. The issue of intentional misrepresentation during classification needs particular attention.

PURPOSE

At present, athletes with VI are placed into competition classes developed on the basis of legal definitions of VI. The International Paralympic Committee Athlete Classification Code states that all sports should have their own classification system designed to reflect the (visual) demands of that individual sport. This project gathered expert opinion on the specific requirements for an evidence-based sport-specific classification system for VI track athletics and to identify any particular issues within track athletics that require further research into their impact on sport performance.

METHODS

A three-round Delphi review was conducted with a panel of 17 people with expertise in VI track athletics.

RESULTS

The panel agreed that the current classification system in VI track athletics does not completely minimize the impact of impairment on competition outcome, highlighting the need for improvements. There was clear agreement that the existing measures of vision may fail to adequately reflect the type of vision loss that would impact running performance, with additional measures required. Intentional misrepresentation, where athletes “cheat” on classification tests, remains a serious concern.

CONCLUSIONS

The panel has identified measures of vision and performance that will inform the development of an evidence-based classification system by better understanding the relationship between VI and performance in track athletics. Issues such as the use of guides and whether the current class system was equitable gave rise to differing opinions within the panel, with these varying across the different running distances.
The Effect of Temporal Information on Placebo Analgesia and Nocebo Hyperalgesia
Authors: Camerone Eleonora Maria , Piedimonte Alessandro , Testa Marco , Wiech Katja , Vase Lene , Zamfira Denisa Adina , Benedetti Fabrizio , Carlino Elisa
Published: October 2020

Objective

Expectations are known to be key determinants of placebo and nocebo phenomena. In previous studies, verbal suggestions to induce such expectations have mainly focused on the direction and magnitude of the effect, whereas little is known about the influence of temporal information.

Methods

Using an experimental placebo and nocebo design, we investigated whether information about the expected onset of a treatment effect modulates the start and time course of analgesic and hyperalgesic responses. Healthy volunteers (n = 166) in three placebo and three nocebo groups were informed that the application of an (inert) cream would reduce (placebo groups) or amplify pain (nocebo groups) after 5, 15, or 30 minutes. Two control groups were also included (natural history and no expectations). Participants’ pain intensity rating of electrical stimuli administered before and 10, 20, and 35 minutes after cream application was obtained.

Results

Mixed-method analysis of variance showed a significant interaction between group and time (F(12,262) = 18.172, p < .001, pη2 = 0.454), suggesting that pain variations differed across time points and between groups. Post hoc comparisons revealed that the placebo and nocebo groups began to show a significantly larger change in perceived pain intensity than the no-expectancy control group at the expected time point (p < .05) but not earlier (p > .05). Once triggered, the analgesic effect remained constant over the course of the experiment, whereas the hyperalgesic effect increased over time.

Conclusions

Our results indicate that temporal suggestions can shape expectancy-related treatment effects, which, if used systematically, could open up new ways to optimize treatment outcome.
Incremental Diagnostic Value of Virtual Noncalcium Dual-Energy Computed Tomography for the Depiction of Cervical Disk Herniation Compared With Standard Gray-Scale Computed Tomography
Authors: Booz Christian , Yel Ibrahim , Martin Simon S. , Lenga Lukas , Eichler Katrin , Wichmann Julian L. , Vogl Thomas J. , Albrecht Moritz H.
Published: October 2020

Objectives

The aim of this study was to investigative the diagnostic accuracy of colored dual-energy computed tomography (CT) virtual noncalcium (VNCa) series for analyzing cervical disk herniation compared with standard gray-scale CT images, with magnetic resonance imaging (MRI) serving as standard of reference.

Materials and Methods

Data from 57 patients who underwent noncontrast dual-source CT and 3.0-Tesla (T) MRI within 2 weeks between January 2017 and December 2018 were retrospectively analyzed. Five radiologists analyzed standard gray-scale dual-energy CT scans for the presence and degree of cervical disk herniation and spinal nerve root impingement. Readers reassessed scans after 8 weeks using colored VNCa series. Two experienced radiologists set the reference standard in consensus MRI reading sessions. Primary indices of diagnostic accuracy for both CT approaches were sensitivity and specificity, which were compared by application of the McNemar test.

Results

A total of 57 patients (mean age, 64 ± 11 years; 30 women) were evaluated (337 intervertebral disks). Magnetic resonance imaging indicated a total of 103 cervical disk herniations. The VNCa reconstructions had higher overall sensitivity compared with gray-scale CT (487/515 [95%; 95% confidence interval (CI), 91%–98%] vs 392/515 [76%; 95% CI, 70%–83%]), as well as higher specificity (1107/1170 [95%; 95% CI, 90%–99%] vs 906/1170 [77%; 95% CI, 72%–82%]) for assessing cervical disk herniation (all P < 0.001). The VNCa reconstructions had higher diagnostic accuracy for analyzing spinal nerve root impingement in comparison with gray-scale CT (sensitivity, 195/230 [85%; 95% CI, 79%–90%] vs 115/230 [50%; 95% CI, 40%–59%]; specificity, 1430/1455 [98%; 95% CI, 94%–100%] vs 1325/1455 [91%; 95% CI, 88%–98%]; accuracy, 1625/1685 [96%; 95% CI, 93%–99%] vs 1440/1685 [86%; 95% CI, 82%–90%]; all P < 0.001).

Conclusions

Color-coded VNCa series improved the diagnostic accuracy for assessing cervical disk herniation and spinal nerve root impingement compared with standard gray-scale CT.
Deep Learning on Conventional Magnetic Resonance Imaging Improves the Diagnosis of Multiple Sclerosis Mimics
Authors: Rocca Maria A. , Anzalone Nicoletta , Storelli Loredana , Del Poggio Anna , Cacciaguerra Laura , Manfredi Angelo A. , Meani Alessandro , Filippi Massimo
Published: October 2020

Objectives

The aims of this study were to present a deep learning approach for the automated classification of multiple sclerosis and its mimics and compare model performance with that of 2 expert neuroradiologists.

Materials and Methods

A total of 268 T2-weighted and T1-weighted brain magnetic resonance imagin scans were retrospectively collected from patients with migraine (n = 56), multiple sclerosis (n = 70), neuromyelitis optica spectrum disorders (n = 91), and central nervous system vasculitis (n = 51). The neural network architecture, trained on 178 scans, was based on a cascade of 4 three-dimensional convolutional layers, followed by a fully dense layer after feature extraction. The ability of the final algorithm to correctly classify the diseases in an independent test set of 90 scans was compared with that of the neuroradiologists.

Results

The interrater agreement was 84.9% (Cohen κ = 0.78, P < 0.001). In the test set, deep learning and expert raters reached the highest diagnostic accuracy in multiple sclerosis (98.8% vs 72.8%, P < 0.001, for rater 1; and 81.8%, P < 0.001, for rater 2) and the lowest in neuromyelitis optica spectrum disorders (88.6% vs 4.4%, P < 0.001, for both raters), whereas they achieved intermediate values for migraine (92.2% vs 53%, P = 0.03, for rater 1; and 64.8%, P = 0.01, for rater 2) and vasculitis (92.1% vs 54.6%, P = 0.3, for rater 1; and 45.5%, P = 0.2, for rater 2). The overall performance of the automated method exceeded that of expert raters, with the worst misdiagnosis when discriminating between neuromyelitis optica spectrum disorders and vasculitis or migraine.

Conclusions

A neural network performed better than expert raters in terms of accuracy in classifying white matter disorders from magnetic resonance imaging and may help in their diagnostic work-up.
What Does Your Pelvic Floor Do for You? Knowledge of the Pelvic Floor in Female University Students: A Cross-sectional Study
Authors: Falvey Leah , Salameh Fadi , O’Sullivan Orfhlaith E. , O’Reilly Barry A.
Published: October 2020

Objectives

To assess the knowledge of the pelvic floor in female university students, including knowledge of pelvic floor structure, function, pelvic floor dysfunction, and pelvic floor muscle exercises (PFMEs).

Methods

The study design is a cross-sectional study via online questionnaire with convenience sampling of female students registered at University College Cork, Ireland for the academic year 2018 to 2019. An online questionnaire was distributed to students at their registered email addresses. Overall knowledge was assessed through 15 questions, looking at pelvic floor structure, function, pelvic floor dysfunction and PFMEs. A score of 1 was allocated to each correct question, with a maximum possible score of 15. Only respondents who answered all 15 questions were included in the analysis. Ethical approval was granted by the Clinical Research and Ethics Committee, Cork, Ireland, on January 4, 2019.

Results

Nine hundred thirty-eight responses were received. There were 72.6% (n = 640) students who had never received information on the pelvic floor. There were 83.9% (n = 691) students who reported that they thought it was important to exercise the pelvic floor. The mean overall knowledge score of 792 respondents was 9.57 (SD, ± 2.72). There was a statistically significant difference (P < 0.001) in the overall knowledge between the students in the school of medicine and health (n = 307, mean = 11.8, SD = 2.35) and the students of other schools (n = 529, mean = 9.39, SD = 2.88).

Conclusions

Knowledge of the pelvic floor in female university students is poor. Further interventions should aim to improve knowledge of the pelvic floor and encourage correct performance of PFMEs in college students.
ICTV Virus Taxonomy Profile: Roniviridae
Authors: Walker Peter J. , Cowley Jeff A. , Dong Xuan , Huang Jie , Moody Nick , Ziebuhr John , Consortium ICTV Report
Published: October 2020

The family Roniviridae includes the genus Okavirus for three species of viruses with enveloped, rod-shaped virions. The monopartite, positive-sense ssRNA genome (26–27 kb) contains five canonical long open reading frames (ORFs). ORF1a encodes polyprotein pp1a containing proteinase domains. ORF1b is expressed as a large polyprotein pp1ab by ribosomal frameshifting from ORF1a and encodes replication enzymes. ORF2 encodes the nucleoprotein. ORF3 encodes two envelope glycoproteins. ORFX encodes a putative double membrane-spanning protein. Roniviruses infect shrimp but only yellow head virus is highly pathogenic. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the family Roniviridae, which is available at ictv.global/report/roniviridae.
Comparison of surgical versus medical termination of pregnancy between 13-20 weeks of gestation in Ethiopia: A quasi-experimental study
Authors: Tufa Tesfaye H. , Prager Sarah , Wondafrash Mekitie , Mohammed Shikur , Byl Nicole , Bell Jason
Published: October 2020

Background

Dilation and evacuation is a method of second trimester pregnancy termination introduced recently in Ethiopia. However, little is known about the safety and effectiveness of this method in an Ethiopian setting. Therefore, the study is intended to determine the safety and effectiveness of dilation and evacuation for surgical abortion as compared to medical abortion between 13-20 weeks’ gestational age.

Methods

This is a quasi-experimental study of women receiving second trimester termination of pregnancy between 13-20 weeks. Patients were allocated to either medical or surgical abortion based on their preference. A structured questionnaire was used to collect demographic information and clinical data upon admission. Procedure related information was collected after the procedure was completed and before the patient was discharged. Additionally, women were contacted 2 weeks after the procedure to evaluate for post-procedural complications. The primary outcome of the study was a composite complication rate. Data were collected using Open Data Kit and then analyzed using Stata version 14.2. Univariate analyses were performed using means (standard deviation), or medians (interquartile range) when the distribution was not normal. Multivariate logistic regression was also performed to control for confounders.

Results

Two hundred nineteen women chose medical abortion and 60 chose surgical abortion. The composite complication rate is not significantly different among medical and surgical abortion patients (15% versus 10%; p=0.52). Nine patients (4.1%) in the medical arm required additional intervention to complete the abortion, while none of the surgical abortion patients required additional intervention. Median (IQR) hospital stay was significantly longer in the medical group at 24 (12-24) hours versus 6(4-6) hours in the surgical group p<0.001.

Conclusion

From the current study findings, we concluded that there is no difference in safety between surgical and medical methods of abortion. This study demonstrates that surgical abortion can be used as a safe and effective alternative to medical abortion and should be offered equivalently with medical abortion, per the patient’s preference.
DPP6 gene in European American Alzheimer’s Disease
Authors: Kirola Laxmi , Budde John P. , Wang Fengxian , Norton Joanne , Morris John C. ,   NIA-LOAD family study group, NCRAD, the ADSP project, Cruchaga Carlos , Fernández Maria Victoria
Published: October 2020

DPP6 encodes a transmembrane protein that expresses highly in the hippocampal regions of the brain and regulates dendritic excitability. Recently, rare and loss of function variants were reported in DPP6 and further demonstrated to be associated with early onset Alzheimer Disease (AD) and frontotemporal dementia. We performed single variant and gene-based analyses in three non-Hispanic white cohorts: a familial late onset AD (cases=1212, controls=341), an unrelated early onset AD (cases=1385, controls=3864) and in the unrelated Alzheimer disease sequencing project (ADSP, cases=5679, controls=4601). Neither single variant or gene-based analysis revealed any significant statistical association of DPP6 variants with the risk for AD in the cohorts examined.
Rapid Development of a De Novo Convalescent Plasma Program in Response to a Global Pandemic: A Large Southeastern U.S. Blood Center’s Experience
Authors: Reik Rita , Gammon Richard R. , Carol Nancy , Smith Judith , Grable Martin , Forbes Susan , Wu Yanyun , Reed Lance , Rogers Michael , Prichard Alicia , Paul Scott , Scholl George
Published: October 2020

Background

With no vaccine or treatment for SARS-CoV-2 and its associated disease, COVID-19, convalescent plasma from recovered COVID-19 (CCP) patients offered a potential therapy. In March of 2020, the United States (US) Food and Drug Administration (FDA) authorized CCP under emergency Investigational New Drug (eIND) exemption and an IRB-approved Expanded Access Program (EAP) to treat severe COVID-19. Hospital demand grew rapidly in the Southeastern US, resulting in backlogs of CCP orders. We describe a large US blood center’s (BC) rapid implementation of a CCP program in response to community needs.

Study Design and Methods

From April 2 to May 17, 2020 CCP was collected by whole blood or apheresis. Initial manual approaches to donor intake, collection and distribution were rapidly replaced with automated processes. All CCP donors and products underwent FDA-required screening and testing.

Results

619 CCP donors (299 females, 320 males) presented for CCP donation [161 (25.6%) whole blood, 466 (74.1%) plasmapheresis] resulting in 1219 CCP units. Production of CCP increased as processes were automated and streamlined, from a mean of 11 donors collected/day for the first month to a mean of 25 donors collected/day in the subsequent two weeks. Backlogged orders were cleared, and inventory began to accumulate 4 weeks after project initiation.

Conclusion

The BC was able to implement an effective de novo CCP collection program within 6 weeks in response to a community need in a global pandemic. Documentation of the experience may inform preparedness for future pandemics.
Wearable Robotic Ankle Resistance Training Improves Neuromuscular Control and Walking Efficiency in Cerebral Palsy
Authors: Conner Benjamin C. , Schwartz Michael H. , Lerner Zachary F.
Published: October 2020

Cerebral palsy (CP) is characterized by deficits in motor function due to reduced neuromuscular control. We leveraged the guiding principles of motor learning theory to design a wearable robotic intervention intended to improve neuromuscular control of the ankle. The goal of this pilot clinical trial was to determine the response to four weeks of exoskeleton ankle resistance therapy (exo-therapy) in children with CP. Five children with CP (12 – 17 years, GMFCS I – II, four males and one female) were recruited for ten, 20-minute sessions of exo-therapy. Surface electromyography, three-dimensional kinematics, and metabolic data were collected at baseline and after training was complete. Changes in neural complexity (via muscle synergy analysis) and metabolic cost were compared to retrospective age- and GMFCS-matched controls who had undergone either single event multi-level orthopedic surgery (SEMLS) or selective dorsal rhizotomies (SDR). Participants displayed decreased co-contraction at the ankle (−29 ± 11%, p = 0.02) and a more typical plantar flexor activation profile (33 ± 13%, p = 0.01), and improvements in neuromuscular control led to a more mechanically-efficient gait pattern (58 ± 34%, p < 0.05) with a reduced metabolic cost of transport (−29 ± 15%, p = 0.02). There were significant increases in neural complexity (5 ± 3%, p = 0.03), where were significantly greater than those seen with SEMLS and SDR (p < 0.01 for both). Ankle exoskeleton resistance therapy shows promise for rapidly improving neuromuscular control for children with CP, and may serve as a meaningful rehabilitative complement to common surgical procedures.
Evaluation of filtration efficacy of various types of facemasks using ambient and PAO aerosols following with different sterilization methods
Authors: Kumar Amit , Bhattacharjee Basundhara , Sangeetha D.N , Subramanian V , Venkatraman B
Published: October 2020

Due to the ongoing pandemic, various types of facemasks such as N-95, surgical mask and cloth masks are being used as an essential protective measure. The filtration efficiency of these masks were tested before and after sterilization by different methods for two flow rates conditions corresponding to normal breathe rate (20 lpm) and during sneezing (90 lpm). Sterilization techniques used here are autoclaving (30 and 60 minutes), dry oven heating (30 and 60 minutes), gamma irradiation (15 and 25 kGy), hot water washing with and without detergent and immersing in 10% concentration of liquid hydrogen peroxide for 30 minutes. As expected, the N-95 is the greatest filtering efficiency among all the other type face masks. The best method to sterilize N-95 masks without affecting its performance is by using dry heat with temperature ranging from 70-80°C. The cloth masks and surgical mask are performed more or less same for both flow conditions. As an affordable sterilization method hot water washing is highly recommended which does not deteriorate the efficiency of the masks and can be used for the general public. The use of double or triple layer cotton cloth masks in the general public serves fit for the purpose than surgical masks. The surgical mask can be sterilized only few times with the help of dry heat, hot water wash and/or autoclave.
SARS-CoV-2 seroprevalence in healthcare workers of dedicated-COVID hospitals and non–COVID hospitals of District Srinagar, Kashmir
Authors: Khan Muhammad Salim , Haq Inaamul , Qurieshi Mariya Amin , Majid Sabhiya , Bhat Arif Akbar , Obaid Muhammad , Qazi Tanzeela Bashir , Chowdri Iqra Nisar , Sabah Iram , Kawoosa Misbah Ferooz , Lone Abdul Aziz , Nabi Shahroz , Sumji Ishtiyaq Ahmad , Kousar Rafiya
Published: October 2020

Background and objective

SARS-CoV-2 infection poses tremendous challenge to the healthcare system of nations across the globe. Serological testing for SARS-CoV-2 infection in healthcare workers, which form a high-risk group, helps in identifying the burden of hidden infection in an institutional setting.

Methods

We present the results of a cross-sectional serosurvey in healthcare workers from two different hospital settings based on their role in the management of SARS-CoV-2 patients in District Srinagar, Kashmir. In addition to testing for the presence of SARS-CoV-2 specific IgG, we collected information on influenza-like symptoms in the last four weeks and the status of RT-PCR testing. SARS-CoV-2 specific IgG antibodies were detected in serum samples using a sensitive and specific chemiluminescent microparticle immunoassay technology.

Interpretation and Conclusion

Of 2915 healthcare workers who participated in the study, we analysed data from 2905 healthcare workers. The overall prevalence of SARS-CoV-2 specific IgG antibodies was 2.5% (95% CI 2.0-3.1) in the healthcare workers of District Srinagar. Healthcare workers who had ever worked at a dedicated-COVID hospital had a substantially lower seroprevalence of 0.6% (95% CI: 0.2 - 1.9). Among healthcare workers who had tested positive for RT-PCR, seroprevalence was 27.6% (95% CI: 14.0 - 47.2).The seroprevalence of SARS-CoV-2 infection in healthcare workers of District Srinagar is low, reflecting that a high proportion of healthcare workers are still susceptible to the infection. It is crucial to lay thrust on infection prevention and control activities and standard hygiene practices by the healthcare staff to protect them from acquiring infection within the healthcare setting.
Abnormal liver tests in admitted patients with SARS-Cov-2 or other respiratory viruses- prognostic similarities and temporal disparities
Authors: Shafran Noa , Issachar Assaf , Shochat Tzippy , Shafran Inbal Haya , Bursztyn Michael , Shlomai Amir
Published: October 2020

Background and Aims

Abnormal liver tests are common in patients with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, but their association with short-term outcomes is controversial. We aimed to compare the pattern of abnormal liver tests in SARS-CoV-2 patients with those of patients infected with influenza or respiratory syncytial virus (RSV), two non-hepatotropic respiratory viruses, and their association with in-hospital mechanical ventilation or death.

Methods

A retrospective cohort study of 1271 hospitalized patients (872 influenza, 218 RSV, and 181 SARS-Cov-2) in a tertiary medical center. We defined abnormal liver tests as GPT, GOT or GGT≥40IU/ML at any time-point during hospitalization.

Results

Abnormal liver tests were mild-moderate in the majority of patients regardless of infection type but the majority of patients with influenza or RSV had a transaminases peak earlier during hospitalization compared to patients with SARS-Cov-2. Abnormal liver tests correlated with markers of severe disease across all types of infections, and were associated with mechanical ventilation or death, occurring mainly in patients with severe liver tests abnormalities (>200IU/L) (27.2%, 39.4% and 55.6% of patients with influenza, RSV or SARS-Cov-2). In multivariate analysis, controlling for age, gender, lymphopenia and CRP, liver tests abnormalities remained significantly associated with mechanical ventilation or death for influenza (OR= 3.047, 95% CI 1.518-6.117) and RSV (OR= 3.402, 95% CI 1.032-11.220) but not for SARS-Cov-2 (OR= 0.995, 95% CI 0.198-4.989). These results were confirmed upon propensity score matching.

Conclusions

Abnormal liver tests during hospitalization with different viral respiratory infections are common, may differ in their time-course and reflect disease severity. They are associated with worse outcomes, mainly in patients with severe liver test abnormalities, regardless of infection type.
Effect of combined cap-assisted, water-aided, and prone position colonoscopy for adenoma detection: A retrospective study
Authors: Ko Jihwan , Ko Byung Gu , Han Seong Ho , Kim Hyung Wook
Published: October 2020

Background

The efficacy of cap-assisted, water-aided, and 12 o’clock-prone position colonoscopy as individual techniques for adenoma detection is well documented. However, the efficacy of the combination of the three colonoscopy methods is unclear. Therefore, the present study aimed to retrospectively compare the efficacy between combined-method colonoscopy (CMC) and standard colonoscopy (SC).

Methods and Findings

A total of 746 patients who underwent either CMC or SC, performed by two board-certified gastroenterologists between December 2019 and March 2020 at Baekyang Jeil Internal Medicine Clinic, were retrospectively evaluated. We evaluated polyp detection rate (PDR), adenoma detection rate (ADR), and mean number of adenomas detected per procedure (MAP). Statistical analysis for comparison between the groups was performed using the Student’s t-test, and ADR and PDR were analyzed using Fisher’s exact test. The study population was predominantly women (55.4%). The mean patient age (standard deviation) was 62.87 (±7.83) years. There was no significant difference in sex, number of fecal occult blood test-positive patients, and age between the two groups. The PDR, ADR, and proximal colon MAP were significantly higher in the CMC group than in the SC group (PDR: 59.8% vs. 84.9%, p < 0.001; ADR: 49.2% vs. 70.1%, p < 0.001; proximal colon MAP: 0.55 vs. 1.24, p < 0.001).

Conclusions

Compared with SC, CMC increases PDR, ADR, and MAP, especially proximal colon MAP. Therefore, CMC may be more useful than SC in clinical settings. This study is the first to evaluate the efficacy of the three techniques in combination.
The impact of the COVID-19 pandemic on the mental health and wellbeing of UK healthcare workers
Authors: Gilleen James , Santaolalla Aida , Valdearenas Lorena , Salice Clara , Fusté Montserrat
Published: October 2020

Background

There is an urgent need to understand the psychological impact the COVID-19 pandemic has had on UK healthcare workers (HCW).

Aims

To reveal risk and protective factors associated with poor mental wellbeing of HCW working during the COVID-19 pandemic in the UK.

Method

2773 UK HCWs completed a survey between 22ndApril and 10th May 2020 containing scales measuring anxiety, depression, PTSD, and stress, and questions about roles and COVID-19-related factors including workplace preparation and risk management. Respondents were classified as high or low symptomatic on each mental health scale and logistic regression revealed risk and protective factors associated with each outcome. Change in wellbeing from pre to during COVID-19 was also quantified.

Results

A large proportion of UK HCW had high mental health symptoms. ‘Fixed’ risk factors of poor mental health included being female, being ‘frontline’, pre-existing mental health diagnoses, and experience of stressful/traumatic events. An additional set of ‘controllable’ factors also significantly increased risk: PPE availability, workload, lack of COVID-19 preparation and training, and insufficient communication of clinical procedures. Resilience and sharing stress reduced risk, as did ethical support for those making treatment decisions. Allied HCW and managers were at elevated risk of high symptoms particularly PTSD. Wellbeing, especially of frontline workers, had significantly worsened compared to before COVID-19.

Conclusions

Poor mental wellbeing was prevalent in HCW during the UK COVID-19 response. A number of controllable factors should be targeted, and protective factors promoted, to reduce the detrimental effect of COVID-19 and other pandemics on HCW mental health.
Establishment & lineage dynamics of the SARS-CoV-2 epidemic in the UK
Authors: du Plessis Louis , McCrone John T. , Zarebski Alexander E. , Hill Verity , Ruis Christopher , Gutierrez Bernardo , Raghwani Jayna , Ashworth Jordan , Colquhoun Rachel , Connor Thomas R. , Faria Nuno R. , Jackson Ben , Loman Nicholas J. , O’Toole Áine , Nicholls Samuel M. , Parag Kris V. , Scher Emily , Vasylyeva Tetyana I. , Volz Erik M. , Watts Alexander , Bogoch Isaac I. , Khan Kamran ,   the COVID-19 Genomics UK (COG-UK) Consortium, Aanensen David M. , Kraemer Moritz U. G. , Rambaut Andrew , Pybus Oliver G.
Published: October 2020

The UK’s COVID-19 epidemic during early 2020 was one of world’s largest and unusually well represented by virus genomic sampling. Here we reveal the fine-scale genetic lineage structure of this epidemic through analysis of 50,887 SARS-CoV-2 genomes, including 26,181 from the UK sampled throughout the country’s first wave of infection. Using large-scale phylogenetic analyses, combined with epidemiological and travel data, we quantify the size, spatio-temporal origins and persistence of genetically-distinct UK transmission lineages. Rapid fluctuations in virus importation rates resulted in >1000 lineages; those introduced prior to national lockdown were larger and more dispersed. Lineage importation and regional lineage diversity declined after lockdown, whilst lineage elimination was size-dependent. We discuss the implications of our genetic perspective on transmission dynamics for COVID-19 epidemiology and control.