bluuebunny/crossref_metadata_2025 huggingface dataset:
Precision association of lymphatic disease spread with radiation-associated toxicity in oropharyngeal squamous carcinomas
Authors: Wentzel Andrew , Luciani Timothy , van Dijk Lisanne V. , Taku Nicolette , Elgohari Baher , Mohamed Abdallah S. R. , Canahuate Guadalupe , Fuller Clifton D. , Vock David M. , Marai G. Elisabeta
Published: September 2020

Purpose

Using a cohort of 582 head and neck cancer patients with nodal disease, we employed clustering over a novel graph-based geometrical representation of lymph node spread in order to identify groups of similar patients. We show that these groups are significantly correlated with radiation-associated dysphagia (RAD), and predictive of late aspiration and feeding tube toxicity.

Materials and methods

All patients received radiotherapy for oropharyngeal cancer (OPC) and had non-metastatic affected lymph nodes in the head and neck. Affected lymph nodes were segmented from pretreatment contrast-enhanced tomography scans and categorized according to consensus guidelines. Similar patients were clustered into 4 groups according to a graph-based representation of affected lymph nodes. Correlation between dysphagia associated symptoms and patient groups was calculated.

Results

Out of 582 patients, 26% (152) experienced toxicity during a follow up evaluation 6 months after completion of radiotherapy treatment. Patient groups identified by our approach were significantly correlated with dysphagia, feeding tube, and aspiration toxicity (p <.0005). Conclusion: Our work successfully stratified a patient cohort into similar groups using a structural geometry, graph-encoding of affected lymph nodes in OPC patients, that were predictive of late radiation-associated dysphagia. Our results suggest that structural geometry-aware characterization of affected lymph nodes can be used to better predict radiation-associated dysphagia at time of diagnosis, and better inform treatment guidelines.
Genetic associations of adult height with risk of cardioembolic and other subtypes of ischaemic stroke: a Mendelian randomisation study in multiple ancestries
Authors: Linden Andrew B , Clarke Robert , Hopewell Jemma C , Guo Yu , Whiteley William N , Lin Kuang , Turnbull Iain , Chen Yiping , Yu Canqing , Lv Jun , Offer Alison , Hammami Imen , Bennett Derrick , Walters Robin G , Li Liming , Chen Zhengming , Parish Sarah ,   for the China Kadoorie Biobank Collaborative Group
Published: September 2020

Background

Taller adult height is associated with lower risks of ischaemic heart disease in both observational and Mendelian randomisation studies, but little is known about the causal relevance of height for different subtypes of ischaemic stroke and the mechanisms involved.

Methods

Height-associated genetic variants (up to 2,931) from previous genome-wide association studies were used to construct genetic instruments in different populations. Two-sample Mendelian randomisation approaches were used to examine the associations of genetically-determined height with ischaemic stroke and its subtypes in multiple ancestries (MEGASTROKE: 60,341 ischaemic stroke cases) supported by additional cases in Europeans (UK Biobank: 4,055 cases) and in Chinese (China Kadoorie Biobank: 10,297 cases). The associations of genetically-determined height with established cardiovascular and other risk factors were also examined in Europeans (UK Biobank: 336,750 participants) and Chinese (China Kadoorie Biobank: 58,277 participants).

Results

Genetically-determined height was inversely associated with ischaemic stroke (4% [95% CI: 1–7] lower risk per 1 standard deviation taller height in MEGASTROKE). This masked much stronger opposing associations of height with different subtypes, with a 12% (95% CI: 6–17) higher risk of cardioembolic stroke, 11% (6–16) lower risk of large-artery stroke, and 14% (9–18) lower risk of small-vessel stroke. Genetically-determined height was strongly positively associated with atrial fibrillation, lean body mass and lung function, and inversely associated with levels of LDL cholesterol and blood pressure in both Europeans and Chinese.

Conclusions

In multiple ancestries, genetic associations support the causal relevance of taller adult height for higher risk of cardioembolic stroke (in addition to atrial fibrillation) and lower risk of other ischaemic strokes, highlighting the need to properly differentiate subtypes of ischaemic stroke in both clinical practice and research.
What is the recovery rate and risk of long-term consequences following a diagnosis of COVID-19? - A harmonised, global longitudinal observational study
Authors: Sigfrid Louise , Cevik Muge , Jesudason Edwin , Lim Wei Shen , Rello Jordi , Amuasi John Humphrey , Bozza Fernando , Palmieri Carlo , Munblit Daniel , Holter Jan Cato , Kildal Anders Benjamin , Russell Clark D , Ho Antonia , Turtle Lance , Drake Thomas M , Beltrame Anna , Hann Katrina , Bangura Ibrahim Richard , Fowler Rob , Lakoh Sulaiman , Berry Colin , Lowe David J , McPeake Joanne , Hashmi Madiha , Dyrhol-Riise Anne Margarita , Donohue Chloe , Plotkin Daniel R , Hardwick Hayley , Elkheir Natalie , Lone Nazir , Docherty Annemarie B , Harrison Ewen M , Baille Kenneth J , Carson Gail , Semple Malcolm G , Scott Janet T
Published: September 2020

Introduction
Very little is known about possible clinical sequelae that may persist after resolution of the acute Coronavirus Disease 2019 (COVID-19). A recent longitudinal cohort from Italy including 143 patients recovered after hospitalisation with COVID-19 reported that 87% had at least one ongoing symptom at 60 day follow-up. Early indications suggest that patients with COVID-19 may need even more psychological support than typical ICU patients. The assessment of risk factors for longer term consequences requires a longitudinal study linked to data on pre-existing conditions and care received during the acute phase of illness.

Methods and analysis
This is an international open-access prospective, observational multi-site study. It will enrol patients following a diagnosis of COVID-19. Tier 1 is developed for following up patients day 28 post-discharge, additionally at 3 to 6 months intervals. This module can be used to identify sub-sets of patients experiencing specific symptomatology or syndromes for further follow up. A Tier 2 module will be developed for in-clinic, in-depth follow up. The primary aim is to characterise physical consequences in patients post-COVID-19. Secondary aim includes estimating the frequency of and risk factors for post-COVID- 19 medical sequalae, psychosocial consequences and post-COVID-19 mortality. A subset of patients will have sampling to characterize longer term antibody, innate and cell-mediated immune responses to SARS-CoV-2.

Ethics and dissemination
This collaborative, open-access study aims to characterize the frequency of and risk factors for long-term consequences and characterise the immune response over time in patients following a diagnosis of COVID-19 and facilitate standardized and longitudinal data collection globally. The outcomes of this study will inform strategies to prevent long term consequences; inform clinical management, direct rehabilitation, and inform public health management to reduce overall morbidity and improve outcomes of COVID-19.
Evaluation of indirect damage and damage saturation effects in dose-response curves of hypofractionated radiotherapy of early-stage NSCLC and brain metastases
Authors: Gago-Arias Araceli , Neira Sara , Pombar Miguel , Gómez-Caamaño Antonio , Pardo-Montero Juan
Published: September 2020

Background

In this work we aim to investigate the possible contribution of indirect damage and damage saturation to tumor control probabilities (TCP) obtained with SBRT/SRS treatments for early-stage NSCLC and brain metastases.

Methods

We have constructed a dataset of early-stage NSCLC and brain metastases response to different fractionations. Dose-response curves were fitted to models based on the linear-quadratic (LQ), the linear-quadratic-linear (LQL), and phenomenological modifications of the LQ model to account for indirect cell damage. We used the Akaike-Information-Criterion formalism to compare performance, and studied the stability of the results with changes in fitting parameters and perturbations on dose/TCP values.

Results

In NSCLC, a modified LQ model with a beta-term increasing with dose yields better results than the LQ model. This rank remains consistent when different fitting parameters are changed, and only the inclusion of very fast accelerated proliferation can eliminate the superiority of the modified LQ. In brain, the LQL model yields the best-fits, and the ranking is not affected by variations of fitting parameters or dose/TCP perturbations.

Conclusions

A modification of the LQ model with a beta-term increasing with dose provides better fits to NSCLC dose-response curves. For brain metastases, the LQL provides the best fit. This may be interpreted as a net contribution of indirect damage in NSCLC, and damage saturation in brain metastases. The results for NSCLC are borderline significant, while those for brain are clearly significant. Our results can assist on the design of optimal radiotherapy for NSCLC and brain metastases, aiming at avoiding over/under-treatment. Dose prescription to such tumors may be reevaluated according to the reported evidence.
The Role of Social Media in Disseminating Plastic Surgery Research: The Relationship between Citations, Altmetrics and Article Characteristics
Authors: Grant Michael C , Scott-Bridge Kai R , Wade Ryckie G
Published: September 2020

Background

Social media (SoMe) enables publishers and authors to disseminate content immediately and directly to interested end-users, on a global scale. Alternative metrics (altmetrics) are non-traditional bibliometrics which describe the exposure and impact of an article on freely available platforms such as Twitter, Facebook, Wikipedia and the news. Altmetrics are strongly associated with ultimate citation counts in various medical disciplines, except plastic surgery which represents the rational for this study.

Methods

Altmetric explorer was used to extract altmetrics and citation rates for articles published during 2018 in Plastic and Reconstructive Surgery (PRS), the Journal of Plastic, Reconstructive and Aesthetic Surgery, the Annals of Plastics Surgery and Plastic Surgery (also known as Chirurgie Plastique). Multivariable negative binomial regression was used to estimate the relationship between citations and predictors (presented as the incidence rate ratio, IRR with 95% confidence interval, CI). Results: Overall, 1215 plastic surgery articles were captured which were cited 3269 times. There was a strong and independent association between the number of mentions in SoMe and the number of times an article was cited (adjusted IRR 1.01 [95% CI 1.01, 1.1]), whereby each mention in SoMe (e.g. Tweets or Facebook posts) translated to one additional citation. Evidence synthesis articles (e.g. systematic reviews) were cited twice as often as other articles and again, the use of SoMe to advertise these outputs was independently associated with more citations (IRR 2.0 [95% CI 1.3, 3.2]).

Conclusions

Dissemination of plastic surgery research through social media channels increases an articles impact as measured by citations.
Previous psychopathology predicted severe COVID-19 concern, anxiety and PTSD symptoms in pregnant women during lockdown in Italy
Authors: Ravaldi Claudia , Ricca Valdo , Wilson Alyce , Homer Caroline , Vannacci Alfredo
Published: September 2020

Italy was the first COVID-19 pandemic epicenter among European countries and established a period of full lockdown, consisting of travel bans, mandatory staying at home and temporary closure of non-essential businesses. Similar measures are known risk factors for psychological disturbances in the general population, still very little is known about their impact on pregnant women’s mental health during COVID-19 pandemic.

The national survey “COVID-19 related Anxiety and StreSs in prEgnancy, poSt-partum and breaStfeeding” (COVID-ASSESS) was conducted during the first month of full lockdown in Italy. The questionnaire was specifically developed to examine COVID-19 concerns and included the psychometric tests NSESSS for PTSD and STAI-Y for anxiety. A multivariable logistic regression model was fitted to explore the association of the concern, anxiety and PTSD symptoms with age, gestational weeks, parity, days of lockdown, assisted reproductive technology use, psychopathological history and previous perinatal losses.

Out of 1015 pregnant women reached, 737 (72.6%) fully answered the questionnaire; no woman reported a COVID-19 infection. Median age was 34.4 years [quartiles 31.7, 37.2], median days in lockdown were 13.1 [11.0, 17.0], median gestational weeks were 27.8 [19.8, 34.0]. Clinically significant PTSD symptoms were present in 75 women (10.2%, NSESSS cut-off 24) and clinically significant anxiety symptoms were present in 160 women (21.7%, STAI-Y1 cut-off 50). Women were less worried about their own health than the health of their baby and of their elderly relatives. Previous anxiety predicted higher concern and PTSD symptoms; previous depression and anxiety were independently associated with current PTSD symptoms.
Knowledge, Attitude, and Practices of Community Pharmacists on Antibiotic Resistance and Antimicrobial Stewardship in Lusaka, Zambia
Authors: Mudenda Steward , Hankombo Mutinta , Saleem Zikria , Sadiq Mohammad Jaffar , Banda Michelo , Munkombwe Derick , Mwila Chiluba , Kasanga Maisa , Zulu Annie Chibwe , Hangoma Jimmy Mapenzi , Mufwambi Webrod , Muungo Lungwani Tyson , Kampamba Ronald Mutati , Bambala Andrew Munkuli , Abdulrahman Noor Mohammed , Akram Muhammad , Muma John Bwalya
Published: September 2020

Antibiotic resistance is among the major threats to global health. Due to limited information on the subject matter in Zambia, we assessed the knowledge, attitude, and practices of community pharmacists on antibiotic resistance and antimicrobial stewardship. We conducted a descriptive cross-sectional study among 144 randomly selected community pharmacists through a structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22 at 95% confidence level. A response rate of 91% (n=144) was achieved. The majority (63%) of the community pharmacists were male and were aged between 30 and 39 years. Interestingly, 93.8% had good knowledge while 67% had positive attitudes. Conversely, 75% of the community pharmacists demonstrated poor practices towards antibiotic resistance and antimicrobial stewardship. Even though community pharmacists had good knowledge and positive attitudes, they demonstrated poor practices that require quick educational interventions. There is a need to promote antimicrobial stewardship sensitization programmes among community pharmacists.
Factors Associated with Good Patient Outcomes Following Convalescent Plasma in COVID-19: A Prospective Phase II Clinical Trial
Authors: Ibrahim Danyal , Dulipsingh Latha , Zapatka Lisa , Eadie Reginald , Crowell Rebecca , Williams Kendra , Wakefield Dorothy B. , Cook Lisa , Puff Jennifer , Hussain Syed A.
Published: September 2020

We conducted a prospective single-arm open-label phase II clinical trial assessing the safety and efficacy of convalescent plasma in hospitalized COVID-19 patients. Convalescent plasma with sufficient IgG titer (1:320) obtained from recovered donors was administered to adult patients with either severe or critical COVID-19 illness. Primary outcomes were adverse events in association with plasma administration, and hospital mortality. Secondary outcomes included disease progression, recovery, length of stay, and hospital discharge. Of the 38 patients included in the analysis, 24 (63%) recovered and were discharged, and 14 (37%) died. Patients who received convalescent plasma early in the disease course (severe illness group) as compared to the patients that received convalescent plasma later in disease progression (critical illness group) had significantly lower hospital mortality 13% vs 55% (p<0.02) and shorter mean hospital length of stay 15.4 vs 33 days (p<0.01). One patient experienced a transient transfusion reaction. No other adverse effects of convalescent plasma infusion were observed. Our results suggest that convalescent plasma is safe and has the potential for positive impact on clinical outcomes including recovery and survival if given to patients early in the course of COVID-19 disease.
Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study
Authors: Lombardi Andrea , Duiella Silvia , Piani Letizia Li , Ceriotti Ferruccio , Oggioni Massimo , Muscatello Antonio , Bandera Alessandra , Gori Andrea , Ferrazzi Enrico
Published: September 2020

Coronavirns disease 2019 is a pandemic viral disease affecting also obstetric patients and uncertainties exist about the prognostic role of inflammatory biomarkers and hemocytometry values in patients with this infection. To clarify that, we assessed the values of several inflammatory biomarkers and hemocytometry variables in a cohort of obstetric patients hospitalized with coronavirus disease 2019 and we correlated the values at admission with the need of oxygen supplementation during the hospitalization. Overall, among 27 (61%) pregnant women and 17 (39%) post-partum women, 6 (14%) patients received oxygen supplementation and 2 (4%) required admission to intensive care unit but none died. During hospitalization neutrophils (p=0.002), neutrophils to lymphocytes ratio (p=0.037) and C reactive protein (p<0.001) decreased significantly, whereas lymphocytes (p<0.001) and platelets (p<0.001) increased. Leukocytes and lymphocytes values at admission were correlated with oxygen need, with respectively a 1% and 5% higher risk of oxygen supplementation for each 1,000 cells decrease. Overall, in obstetric patients hospitalized with coronavirus disease 2019, C reactive protein is the inflammatory biomarker that better mirrors the course of the disease whereas D-dimer or ferritin are not reliable predictors of poor outcome. Care to the need of oxygen supplementation should be reserved to patients with reduced leukocytes or lymphocytes values at admission.
12 Novel Clonal Groups of Leptospira Infecting Humans in Multiple Contrasting Epidemiological Contexts in Sri Lanka
Authors: Jayasundara JMDD , Senavirathna RMISK , Warnasekara YPJN , Gamage CD , Siribaddana S , Kularatne SAM , Matthias M , Mariet JF , Picardeau M , Agampodi SB , Vinetz JM
Published: September 2020

Leptospirosis is a ubiquitous disease and a major clinical challenge owing to the multitude of clinical presentations and manifestations that are possibly attributable to the diversity of Leptospira, the understanding of which is key to study the epidemiology of this emerging global disease threat. Sri Lanka is a hotspot for leptospirosis with high levels of endemic disease as well as annual epidemics. We carried out a prospective study of Leptospira diversity in Sri Lanka, covering the full range of climatic zones, geography, and clinical severity. Samples were collected for leptospiral culture from 1192 patients from 15 of 25 districts in Sri Lanka over two and half years period. Twenty-five isolates belonging to four pathogenic Leptospira species were identified: L. interrogans, L. borgpetersenii, L. weilii, and L. kirschneri. At least six serogroups were identified among the isolates: Autumnalis (6), Pyrogenes (4), Icterohaemorrhagiae (2), Celledoni (1), Grippotyphosa (2) and Bataviae (1). Seven isolates did not agglutinate using available antisera panels, suggesting new serogroups. Isolates were sequenced by Illumina. These data add 25 new core genome sequence types and were clustered in 15 clonal groups, including 12 new clonal groups. L. borgpetersenii was found only in the dry zone and L. weilii only in the wet zone. Acute kidney injury and cardiovascular involvement were seen only with L. interrogans infections. Thrombocytopenia and liver impairment were seen in both L. interrogans and L. borgpetersenii infections. The inadequate sensitivity of culture isolation to identify infecting Leptospira species underscores the need for culture-independent typing methods for Leptospira.

Author Summary

There is a huge diversity in pathogenic Leptospira species worldwide, and our knowledge of the currently circulating species is deficient owing to limited isolation and identification of Leptospira species from endemic countries. This prospective study reveals the wide pathogen diversity that causes human leptospirosis in Sri Lanka, representing four species, more than eight serogroups, and fifteen clonal groups. Further, the different geographic and climatic zone distributions and clinical manifestations observed underscores the need for prospective studies to expand the molecular epidemiological approaches to combat leptospirosis
Diagnostic accuracy at the first episode of psychosis in Uganda
Authors: Nanteza Angel , Mwesiga Emmanuel K. , Nakku Juliet , Nakasujja Noeline , Akena Dickens
Published: September 2020

Background

Correct clinical diagnosis at the first episode of psychosis may be difficult due to many non-specific symptoms. We aimed to determine the factors associated with a correct diagnosis among patients with a first episode of psychosis in Uganda.

Methods

A cross sectional study design was performed at the Butabika National Referral Mental Hospital in Uganda. We included treatment naïve participants aged 18 to 60 years with a diagnosis of a psychotic disorder. Patients with organic disorders like HIV/AIDS, syphilis and substance use disorders were excluded. The MINI international neuropsychiatric inventory was administered to confirm the clinical diagnosis. Concordance was based on the percentage agreement and kappa statistic between the admission chart diagnosis and the MINI diagnosis.

Results

178 participants with a first episode of psychosis were included into the final analysis. The agreement between the MINI diagnosis and clinician diagnosis was 0.385, (P < 0.001) with a concordance of 49.5%. After controlling for nationality and the household’s source of income, duration of untreated psychosis, [p-value 0.028(95%CI: 0.07-0.89)], living with a primary family member, [p-value 0.038(95%CI:0.95-2.86)] and cadre of the clinician who made the initial diagnosis[Medical officer, [p-value 0.011(95%CI: 0.18-0.80)] were associated with a correct diagnosis.

Conclusion

We found low agreement between clinician diagnoses and MINI diagnoses at the first episode of psychosis. Improved training of staff while considering the duration of untreated psychosis and the living arrangements of the patient are required to improve diagnostic accuracy in this population.
Diagnostic power of resting-state fMRI for detection of network connectivity in Alzheimer’s disease and Mild Cognitive Impairment: A systematic review
Authors: Ibrahim Buhari , Nasser Nisha Syed , Ibrahim Normala , Mohamed Mazlyfarina , Hassan Hasyma Abu , Saripan M. Iqbal , Suppiah Subapriya
Published: September 2020

Resting state fMRI (rs-fMRI) detects functional connectivity (FC) abnormalities that occur in the brains of patients with Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI). FC of the default mode network (DMN), which is involved in memory consolidation, is commonly impaired in AD and MCI. We aimed to determine the diagnostic power of rs-fMRI to identify FC abnormalities in the DMN, which help to distinguish patients with AD or MCI from healthy controls (HCs). We searched articles in PubMed and Scopus databases using the search terms such as AD, MCI, resting-state fMRI, sensitivity and specificity through to 27th March 2020 and removed duplicate papers. We screened 390 published articles, and shortlisted 12 articles for the final analysis. The range of sensitivity of DMN FC at the posterior cingulate cortex (PCC) for diagnosing AD was between 65.7% - 100% and specificity ranged from 66 - 95%. Reduced DMN FC between the PCC and anterior cingulate cortex (ACC) in the frontal lobes was observed in MCI patients. AD patients had impaired FC in most regions of the DMN; particularly the PCC in early AD. This indicates that DMN’s rs-fMRI FC can offer moderate to high diagnostic power to distinguish AD and MCI patients. fMRI detected abnormal DMN FC, particularly in the PCC that helps to differentiate AD and MCI patients from healthy controls (HCs). Combining multivariate method of analysis with other MRI parameters such as structural changes improve the diagnostic power of rs-fMRI in distinguishing patients with AD or MCI from HCs.
Systematic Review and Meta-Analysis: Relationships Between Attention-Deficit/Hyperactivity Disorder and Daytime Urinary Symptoms in Children
Authors: Mahjani Behrang , Renström Koskela Lotta , Gustavsson Mahjani Christina , Janecka Magdalena , Batuure Anita , Hultman Christina M , Reichenberg Abraham , Buxbaum Joseph D , Grice Dorothy E
Published: September 2020

Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children.
We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS.
We identified 117 relevant articles in the literature and 17 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI: 1.13,7.88, P < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles.
Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.
The Association between Gut Microbiota and Osteoporosis was Mediated by Amino Acid Metabolism: Multi-omics Integration in a Large Adult Cohort
Authors: Ling Chu-wen , Miao Zelei , Xiao Mian-li , Zhou Hong-wei , Jiang Zengliang , Fu Yuanqing , Xiong Feng , Zuo Luo-shi-yuan , Liu Yu-ping , Wu Yan-yan , Jing Li-peng , Dong Hong-Li , Chen Geng-dong , Ding Ding , Wang Cheng , Zeng Fang-fang , He Yan , Zheng Ju-Sheng , Chen Yu-ming
Published: September 2020

Several small studies suggested gut microbiome might influence osteoporosis, but rare metabolomics evidence from human study had explained the link. This study examined the association of gut microbiome dysbiosis with osteoporosis and explored the potential pathways by using fecal and serum metabolomics. We analyzed gut microbiota compositions by 16S rRNA profiling and bone density (BMD) using a dual-energy X-ray absorptiometry in 1776 community-based adults. Targeted metabolomics in feces (15 categories) and serum (12 categories) were further analyzed in 971 participants with ultra-performance liquid chromatography coupled to tandem mass spectrometry. This study showed osteoporosis was related to gut microbiota beta diversity, taxonomy and functional composition. The relative abundance of Actinobacillus, Blautia, Oscillospira, Bacteroides and Phascolarctobacterium was positively, while Veillonellaceae other, Collinsella and Ruminococcaceae other were inversely, associated with the presence of osteoporosis, which related to higher levels of peptidases and transcription machinery in microbial function. Fecal and serum metabolomics analyses suggested that the tyrosine metabolism and the tryptophan metabolism in feces and the valine, leucine and isoleucine degradation in serum were significantly linked to the identified microbiota biomarkers and osteoporosis. This large population-based study provided the robust evidence connecting gut dysbiosis, fecal and serum metabolomics with osteoporosis. Our results suggested that gut dysbiosis and amino acid metabolism could be potential targets for the intervention of osteoporosis.
Epidemiology of Venous Thromboembolism in SARS-CoV-2 Infected Patients: A Systematic Review and Meta-Analysis
Authors: Maitra Souvik , Baidya Dalim K , Bhattacharjee Sulagna , Anand Rahul K , Ray Bikash R
Published: September 2020

Early reports from China and Europe indicated that incidence of venous thromboembolism in COVID-19 patients may be high. In this meta-analysis of observational studies was designed to know worldwide prevalence of thromboembolic events in COVID-19 patients. Primary outcome of our review was to assess the proportion of patients with VTE. Secondary outcomes were to assess the proportion of patients’ with DVT and proportion of patients with PE. Random effect meta-analysis model with restricted maximum likelihood estimator was used for all analysis. Pooled proportion with 95% confidence interval (95% CI) and heterogeneity (I2) was reported for all outcomes. Data of 5426 patients from n=19 articles were included in this systematic review and meta-analysis. Incidence of VTE (95% CI), PE (95% CI) and DVT (95% CI) was 23 (10-36) %, 12 (6-17) % and 15 (8-23) %. We have found a high but incidence of thromboembolic events in COVID-19 patients. Further well-designed studies are required in this area to identify true incidence and risk factors of it.

Key Messages

This meta-analysis of observational studies was designed to know worldwide prevalence of thromboembolic events in COVID-19 patients.

Data of more than 5000 patients from 19 observational studies were analyzed in this meta-analysis.

Incidence of venous thromboembolism may be as high as 36% in these patients.
Beneficial Effect of Corticosteroids in Preventing Mortality in Patients Receiving Tocilizumab to Treat Severe COVID-19 Illness
Authors: Rubio-Rivas Manuel , Ronda Mar , Padulles Ariadna , Mitjavila Francesca , Riera-Mestre Antoni , García-Forero Carlos , Iriarte Adriana , Mora Jose M. , Padulles Nuria , Gonzalez Monica , Solanich Xavier , Gasa Merce , Suarez Guillermo , Sabater Joan , Perez-Fernandez Xose L. , Santacana Eugenia , Leiva Elisabet , Ariza-Sole Albert , Dallaglio Paolo D. , Quero Maria , Soriano Antonio , Pasqualetto Alberto , Koo Maylin , Esteve Virginia , Antoli Arnau , Moreno Rafael , Yun Sergi , Cerda Pau , Llaberia Mariona , Formiga Francesc , Fanlo Marta , Montero Abelardo , Chivite David , Capdevila Olga , Bolao Ferran , Pinto Xavier , Llop Josep , Sabate Antoni , Guardiola Jordi , Cruzado Josep M. , Comin-Colet Josep , Santos Salud , Jodar Ramon , Corbella Xavier
Published: September 2020

Introduction

On the basis of the preliminary report from the RECOVERY trial, the use of dexamethasone or alternative corticosteroids (CS) is currently recommended in severe COVID-19 patients requiring supplemental oxygen. However, last updated recommendations have not taken a position either for or against the use of other immunomodulators such as tocilizumab (TCZ), with or without CS, since results are still limited.

Methods

From March 17 to April 7, 2020, a real-world observational retrospective analysis was conducted at our 750-bed university hospital to study the characteristics and risk factors for mortality in patients with severe COVID-19 treated with TCZ +/-CS, in addition to standard of care (SOC). Data were obtained from routine clinical practice, stored in electronic medical records. The main outcome was all-cause in-hospital mortality.

Results

A total of 1,092 COVID-19 patients were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186, 155 (83.3 %) patients were receiving non-invasive ventilation when TCZ +/-CS was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (± 4.3) and 4.3 days (± 3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR=1.09, p<0.001), chronic heart failure (HR=4.4, p=0.003), and chronic liver disease (HR=4.69, p=0.004). The use of CS, in combination with TCZ, was the main protective factor against mortality (HR=0.26, p<0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up.

Conclusions

In severe COVID-19 patients receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed beneficial effect in preventing in-hospital mortality.
cFIT: Integration and transfer learning of single cell transcriptomes, illustrated by fetal brain cell development
Authors: Peng Minshi , Li Yue , Wamsley Brie , Wei Yuting , Roeder Kathryn
Published: September 2020

Large, comprehensive collections of scRNA-seq data sets have been generated that allow for the full transcriptional characterization of cell types across a wide variety of biological and clinical conditions. As new methods arise to measure distinct cellular modalities, a key analytical challenge is to integrate these data sets or transfer knowledge from one to the other to better understand cellular identity and functions. Here, we present a simple yet surprisingly effective method namedcFITfor capturing various batch effects across experiments, technologies, subjects, and even species. The proposed method models the shared information between various data sets by a common factor space, while allowing for unique distortions and shifts in gene-wise expression in each batch. The model parameters are learned under an iterative non-negative matrix factorization (NMF) framework and then used for synchronized integration from across-domain assays. In addition, the model enables transferring via low-rank matrix from more informative data to allow for precise identification in data of lower quality. Compared to existing approaches, our method imposes weaker assumptions on the cell composition of each individual data set, however, is shown to be more reliable in preserving biological variations. We apply cFIT to multiple scRNA-seq data sets of developing brain from human and mouse, varying by technologies and developmental stages. The successful integration and transfer uncover the transcriptional resemblance across systems. The study helps establish a comprehensive landscape of brain cell type diversity and provides insights into brain development.
Genome-wide identification of tomato xylem sap fitness factors for three plant-pathogenicRalstoniaspecies
Authors: Georgoulis Stratton J. , Shalvarjian Katie E. , Helmann Tyler C. , Hamilton Corri D. , Carlson Hans K. , Deutschbauer Adam M. , Lowe-Power Tiffany M.
Published: September 2020

Plant pathogenicRalstoniaspp. colonize plant xylem and cause wilt diseases on a broad range of host plants. To identify genes that promote growth of diverseRalstoniastrains in xylem sap from tomato plants, we performed genome-scale genetic screens (random barcoded transposon mutant sequencing screens; RB-TnSeq) in three strains spanning the genetic, geographical, and physiological range of plant pathogenicRalstonia: R. solanacearumIBSBF1503,R. pseudosolanacearumGMI1000, andR. syzygiiPSI07. Contrasting mutant fitness phenotypes in culture media versus in xylem sap suggest thatRalstoniastrains are adapted toex vivoxylem sap and that culture media impose foreign selective pressures. Although wild-typeRalstoniagrew in sap and in rich medium with similar doubling times and to a similar carrying capacity, more genes were essential for growth in sap than in rich medium. Each strain required many genes associated with envelope remodeling and repair processes for full fitness in xylem sap. These genes were associated with peptidoglycan peptide formation (murI), secretion of periplasmic proteins (tatC), periplasmic protein folding (dsbA), synthesis of osmoregulated periplasmic glucans (mdoGH), and LPS biosynthesis. Mutants in four genes had strong, sap-specific fitness defects in all strain backgrounds:murI, thiC, purU, and a lipoprotein (RSc2007). Many amino acid biosynthesis genes were required for fitness in both minimal medium and xylem sap. Multiple mutants with insertions in virulence regulators had gains-of-fitness in culture media and neutral fitness in sap. Our genome-scale genetic screen identifiedRalstoniafitness factors that promote growth in xylem sap, an ecologically relevant condition.

Importance

Traditional transposon mutagenesis genetic screens pioneered molecular plant pathology and identified core virulence traits like the type III secretion system. TnSeq approaches that leverage next-generation sequencing to rapidly quantify transposon mutant phenotypes are ushering in a new wave of biological discovery. Here we have adapted a genome-scale approach, random barcoded transposon mutant sequencing (RB-TnSeq), to discover fitness factors that promote growth of three related bacterial strains in a common niche, tomato xylem sap. Fitness of wild-type and mutants show thatRalstoniaspp. are adapted to grow well in xylem sap from their natural host plant, tomato. Our screen identified multiple sap-specific fitness factors with roles in maintaining the bacterial envelope. These factors include putative adaptations to resist plant defenses that may include antimicrobial proteins and specialized metabolites that damage bacterial membranes.
Mixed knobs in corn cobs
Authors: Lamelza Piero , Lampson Michael A.
Published: September 2020

Maize heterochromatic knobs cheat female meiosis by forming neocentromeres that bias their segregation into the future egg cell. In this issue of Genes & Development, Swentowsky and colleagues (pp. 1239–1251) show that two types of knobs, those composed of 180-bp and TR1 sequences, recruit their own novel and divergent kinesin-14 family members to form neocentromeres.
Determinants of entrepreneurial small and medium enterprises performance with the interaction effect of commercial loans
Authors: Khan Muhammad Asif , Siddique Asima , Sarwar Zahid , Minh Huong Le Thi , Nadeem Qaiser
Published: September 2020

Purpose

The purpose of this study is to investigate the interaction effect of commercial loans in between trade Credit, retain earning, and entrepreneurial small and medium enterprises (SMEs) performance.

Design/methodology/approach

In this research, the cross-sectional research design was used, and data were collected from 362 SMEs located in Pakistan by using a questionnaire. Correlation and regression analysis was adopted to establish the interaction effect of commercial loans in between trade credits, retain earning and entrepreneurial SMEs performance.

Findings

The results demonstrated that commercial loans, trade credit and retain earning have a positive relationship with entrepreneurial SMEs performance. The findings also confirmed the interaction effect of commercial loans in between retain earnings, trade credit and entrepreneurial SMEs performance.

Originality/value

The study examined the association and interaction effect of commercial loans in between retain earnings, trade credit and SMEs performance in the emerging state (Pakistan). So, this is the first time to study the relationship between these variables, which highly contributes to entrepreneurial SMEs literature.
Framework to manage humanitarian logistics in disaster relief supply chain management in India
Authors: Negi Saurav , Negi Gaurav
Published: September 2020

Purpose

The purpose of this paper is to identify the issues and challenges in humanitarian logistics and to develop a framework for effectively managing the humanitarian logistics in disaster relief supply chain operations in India.

Design/methodology/approach

This paper presents a framework to manage humanitarian logistics effectively in disaster management through qualitative analysis. First, the author examines the challenges facing the humanitarian logistics and supply chain through the reviews of the literature on various disasters. Then, the author presented a framework based on the best practices and initiatives taken worldwide in the preparedness and response stage of the humanitarian supply chain to manage and reduce the aftermath of any disaster in context to India.

Findings

A framework has been developed to manage humanitarian logistics in the disaster relief operation, which would improve the humanitarian supply chain in India and help to effectively manage natural disasters in the preparedness and response stage at the state and district levels.

Research limitations/implications

The paper mainly emphasises on the preparedness and response stage of disaster supply chain management in Indian context.

Practical implications

None of the disaster incidents can be stopped from taking place, but the impact can be minimised by proper preparedness and effective response during the operations of humanitarian logistics. With this hope, the framework has been developed, which if implemented would help to plan and manage any disaster incident in an effective manner, which ultimately would save millions of lives and cost in terms of infrastructure, property, assets etc.

Originality/value

As natural disaster incidents are occurring frequently in Indian states, there is an urgent need for a framework to manage the logistics operations effectively and efficiently during any disaster relief operations. Limited literature is found on developing and presenting a framework focusing on the preparedness and response phase of disaster supply chain management in context to India. Hence, this paper is believed to be the first to fulfil this gap with main emphasis on the preparedness and response stage of disaster supply chain management in Indian scenario.
Fostering digital citizens: perceptions of sensitivity training
Authors: Karaatmaca Ceren , Altinay Fahriye , Altinay Zehra , Dagli Gokmen , Akcil Umut
Published: September 2020

Purpose

The aim of the study is to evaluate the perceptions of participants on the sensitivity training in conducting online context.

Design/methodology/approach

The researchers focus on the knowledge and attitudes of digital citizens as well as their perceptions on sensitivity training taking into consideration the technological aspects. In this qualitative approach, the available data were collected from 25 students from both graduate and undergraduate levels from different fields via an open-ended questionnaire in order to get their perceptions about creating a sensitivity training in the online context. In the questionnaire, metaphors were also used.

Findings

The themes derived from these metaphors and additional themes formed by narratives about technology and sensitivity equality feeding digital citizens allow ways to be examined and emphasize the importance of sensitivity training in technology and communication areas.

Research limitations/implications

Both direct and indirect thoughts of the participants are limitations of the study.

Practical implications

Preparing students adequately for sensitivity in the workplace is a constant teaching and learning challenges in higher education.

Social implications

This study focuses on universal values in a digital society in order to shed a light on sensitivity training in preventing conflicts in the global world.

Originality/value

The study focuses on the capacity of fostering digital citizens in e-society based on universal values and sensitivity training.
The mediating role of intellectual capital in corporate governance and the corporate performance relationship
Authors: Shahwan Tamer Mohamed , Fathalla Mohamed Mahmoud
Published: September 2020

Purpose

This paper aims to investigate the impact of intellectual capital (IC) as a mediator variable on the association between corporate governance (CG) practices and firm performance. This study also examines bi-causality linkages between these variables.

Design/methodology/approach

The designated corporate governance index and the value-added intellectual coefficient method were used to assess the level of CG practices and the performance of IC. Tobin’s Q (TQ) and operating efficiency ratio were used to measure firm performance.

Findings

The aggregate CG score has a significant positive impact on the IC and the two measures of firm performance. However, the IC has only a partial mediation effect on the relationship between the aggregate corporate governance score and a firm’s operational efficiency ratio. The IC has partial and full mediation effects in the relationship between the sub-dimensions of corporate governance and the performance of Egyptian corporates. Moreover, a bi-causality relationship can be observed between CG and TQ.

Research limitations/implications

Generalizing the obtained results would require the sample size to be extended.

Practical implications

The findings should alert legislative institutions and practitioners of the need to comply with good CG practices and develop the efficiency of IC to elicit a firm’s superior performance.

Originality/value

This study is one of the first attempts to investigate the causality relationships and the mediation impact of IC on the relationship between CG practices and corporate performance in the Egyptian context.
Life expectancy and trade openness: causality in Latin America
Authors: Akyuz Mert , Karul Cagin , Demir Ibrahim
Published: September 2020

Purpose

The aim of this research is to investigate the causal relationship between trade openness (TO) and life expectancy (LE) at birth in Latin American countries over the period of 1980–2014.

Design/methodology/approach

The bootstrap panel Granger causality test proposed by Emirmahmutoglu and Kose (2011) was used to determine the direction of causality in the presence of cross-sectional dependency and heterogeneity among Latin American countries. Also, four different tests were employed in order to determine the cross-sectional dependency and slope homogeneity. The stationarity properties of variables were inspected by employing a unit root test.

Findings

The findings indicated that Granger causality existed between TO and LE, at birth which was running from the former to the latter for panel. On a country basis, TO Granger caused LE at birth for countries with low level of economic development and higher taxes on income and profits.

Practical implications

This study provides new insights for policymaking regarding the role of TO in achieving comprehensive economic reforms to increase LE at birth during a period of intense trade rivalry across nations.

Originality/value

Although research in the literature has mainly focused on the impact of TO on LE at birth with panel data, most studies ignored the regional effects. It is the authors’ concern that the direction of causality can be country-specific and have regional characteristics. In this regard, instead of dividing countries for a specific region into two parts such as developing and developed, the authors investigated the pattern of trade–health link for a specific region, Latin America.