bluuebunny/crossref_metadata_2025 huggingface dataset:
Insertion of plastidic β-barrel proteins into the outer envelopes of plastids involves an intermembrane space intermediate formed with Toc75-V/OEP80
Authors: Gross Lucia E , Klinger Anna , Spies Nicole , Ernst Theresa , Flinner Nadine , Simm Stefan , Ladig Roman , Bodensohn Uwe , Schleiff Enrico
Published: February 2021

The insertion of organellar membrane proteins with the correct topology requires the following: First, the proteins must contain topogenic signals for translocation across and insertion into the membrane. Second, proteinaceous complexes in the cytoplasm, membrane, and lumen of organelles are required to drive this process. Many complexes required for the intracellular distribution of membrane proteins have been described, but the signals and components required for the insertion of plastidic β-barrel-type proteins into the outer membrane are largely unknown. The discovery of common principles is difficult, as only a few plastidic β-barrel proteins exist. Here, we provide evidence that the plastidic outer envelope β-barrel proteins OEP21, OEP24, and OEP37 from pea (Pisum sativum) and Arabidopsis thaliana contain information defining the topology of the protein. The information required for the translocation of pea proteins across the outer envelope membrane is present within the six N-terminal β-strands. This process requires the action of translocon of the outer chloroplast (TOC) membrane. After translocation into the intermembrane space, β-barrel proteins interact with TOC75-V, as exemplified by OEP37 and P39, and are integrated into the membrane. The membrane insertion of plastidic β-barrel proteins is affected by mutation of the last β-strand, suggesting that this strand contributes to the insertion signal. These findings shed light on the elements and complexes involved in plastidic β-barrel protein import.
The state of oligomerization of Rubisco controls the rate of synthesis of the Rubisco large subunit in Chlamydomonas reinhardtii
Authors: Wietrzynski Wojciech , Traverso Eleonora , Wollman Francis-André , Wostrikoff Katia
Published: February 2021

Ribulose 1,5-bisphosphate carboxylase/oxygenase (Rubisco) is present in all photosynthetic organisms and is a key enzyme for photosynthesis-driven life on Earth. Its most prominent form is a hetero-oligomer in which small subunits (SSU) stabilize the core of the enzyme built from large subunits (LSU), yielding, after a chaperone-assisted multistep assembly process, an LSU8SSU8 hexadecameric holoenzyme. Here we use Chlamydomonas reinhardtii and a combination of site-directed mutants to dissect the multistep biogenesis pathway of Rubisco in vivo. We identify assembly intermediates, in two of which LSU are associated with the RAF1 chaperone. Using genetic and biochemical approaches we further unravel a major regulation process during Rubisco biogenesis, in which LSU translation is controlled by its ability to assemble with the SSU, via the mechanism of control by epistasy of synthesis (CES). Altogether this leads us to propose a model whereby the last assembly intermediate, an LSU8-RAF1 complex, provides the platform for SSU binding to form the Rubisco enzyme, and when SSU is not available, converts to a key regulatory form that exerts negative feedback on the initiation of LSU translation.
The NAC transcription factor FaRIF controls fruit ripening in strawberry
Authors: Martín-Pizarro Carmen , Vallarino José G , Osorio Sonia , Meco Victoriano , Urrutia María , Pillet Jeremy , Casañal Ana , Merchante Catharina , Amaya Iraida , Willmitzer Lothar , Fernie Alisdair R , Giovannoni James J , Botella Miguel A , Valpuesta Victoriano , Posé David
Published: February 2021

In contrast to climacteric fruits such as tomato, the knowledge on key regulatory genes controlling the ripening of strawberry, a nonclimacteric fruit, is still limited. NAC transcription factors (TFs) mediate different developmental processes in plants. Here, we identified and characterized Ripening Inducing Factor (FaRIF), a NAC TF that is highly expressed and induced in strawberry receptacles during ripening. Functional analyses based on stable transgenic lines aimed at silencing FaRIF by RNA interference, either from a constitutive promoter or the ripe receptacle-specific EXP2 promoter, as well as overexpression lines showed that FaRIF controls critical ripening-related processes such as fruit softening and pigment and sugar accumulation. Physiological, metabolome, and transcriptome analyses of receptacles of FaRIF-silenced and overexpression lines point to FaRIF as a key regulator of strawberry fruit ripening from early developmental stages, controlling abscisic acid biosynthesis and signaling, cell-wall degradation, and modification, the phenylpropanoid pathway, volatiles production, and the balance of the aerobic/anaerobic metabolism. FaRIF is therefore a target to be modified/edited to control the quality of strawberry fruits.
Functional redox links between lumen thiol oxidoreductase1 and serine/threonine-protein kinase STN7
Authors: Wu Jianghao , Rong Liwei , Lin Weijun , Kong Lingxi , Wei Dengjie , Zhang Lixin , Rochaix Jean-David , Xu Xiumei
Published: February 2021

In response to changing light quantity and quality, photosynthetic organisms perform state transitions, a process which optimizes photosynthetic yield and mitigates photo-damage. The serine/threonine-protein kinase STN7 phosphorylates the light-harvesting complex of photosystem II (PSII; light-harvesting complex II), which then migrates from PSII to photosystem I (PSI), thereby rebalancing the light excitation energy between the photosystems and restoring the redox poise of the photosynthetic electron transport chain. Two conserved cysteines forming intra- or intermolecular disulfide bonds in the lumenal domain (LD) of STN7 are essential for the kinase activity although it is still unknown how activation of the kinase is regulated. In this study, we show lumen thiol oxidoreductase 1 (LTO1) is co-expressed with STN7 in Arabidopsis (Arabidopsis thaliana) and interacts with the LD of STN7 in vitro and in vivo. LTO1 contains thioredoxin (TRX)-like and vitamin K epoxide reductase domains which are related to the disulfide-bond formation system in bacteria. We further show that the TRX-like domain of LTO1 is able to oxidize the conserved lumenal cysteines of STN7 in vitro. In addition, loss of LTO1 affects the kinase activity of STN7 in Arabidopsis. Based on these results, we propose that LTO1 helps to maintain STN7 in an oxidized active state in state 2 through redox interactions between the lumenal cysteines of STN7 and LTO1.
Self-made university rankings: Categorization tactics and communication activism in Italian universities
Authors: Bonaccorsi Andrea , Belingheri Paola , Blasi Brigida , Romagnosi Sandra
Published: February 2021

Higher education institutions increasingly live in environments in which they are subject to evaluation and rankings. We examine the way in which Italian (mostly public) universities adapted to the new landscape created by the official research assessments, which have produced rankings at national level, published in 2013 and 2016. We compare the media coverage of rankings after the first research assessment (covering 2004–10) and the second one (2011–4). By examining the same type of media data longitudinally, replicating regression analysis, and using robustness checks, we discover a remarkable degree of organizational adaptation. After the initial shock following the first research assessment (2004–10), in which universities were mostly passive, universities rapidly learnt how to deal with rankings. After the second exercise, they actively and professionally communicated with the media, building up self-made rankings data aimed at protecting and enhancing their image, using a range of categorization tactics.
Optimal Taxation with Private Insurance
Authors: Chang Yongsung , Park Yena
Published: February 2021

We derive a fully non-linear optimal income tax schedule in the presence of private insurance. We fill the gap in the literature by studying the optimal tax formula with a comprehensive structure of the private markets—including incomplete markets models—both theoretically and quantitatively. As in the standard taxation literature without private insurance, the optimal tax formula can still be expressed in terms of standard sufficient statistics. With private insurance, however, the formula involves additional terms that reflect how the private market interacts with public insurance. For example, the optimal tax formula should also consider asset distribution and pecuniary externalities as well as the welfare effects of borrowing constraints.
Psychosis in systemic lupus erythematosus (SLE): 40-year experience of a specialist centre
Authors: Abrol Esha , Coutinho Ester , Chou Michael , Hart Melanie , Vincent Angela , Howard Robert , Zandi Michael S , Isenberg David
Published: February 2021

Objectives

The long-term outcome of psychosis in association with systemic lupus erythematosus (SLE) has been insufficiently characterised. We used a specialist centre cohort of patients with SLE and psychosis to investigate their clinical outcome and phenotypic and laboratory characteristics.

Methods

Retrospective cohort study of 709 SLE patients seen at a specialist centre between January 1978 and November 2018. Clinical, biochemical and immunological characteristics (Bonferroni corrected), and serum neuronal surface antibody profile using novel cell-based assays, were compared between patients with and without psychosis.

Results

Eighteen (18/709, 2.5%) patients developed lupus psychosis over a mean ± SD of 17.5 ± 11.0 years follow-up. Psychosis fully remitted in 66.7% (12/18) with a combination of antipsychotic (in 38.9%) and immunosuppressive therapy (methylprednisolone 72.2%, cyclophosphamide 55.6%, rituximab 16.7%, plasma exchange 27.8%, prednisolone 50%). Patients who developed lupus psychosis may be more likely to have anti-RNP antibodies (50.0% vs 26.5%) and less likely to have anti-cardiolipin antibodies (5.6% vs 30.0%), but this was not significant in our small sample. Neuronal surface autoantibody tests found GABABR autoantibodies in 3/10 (30.0%) lupus psychosis patients compared with only 3/27 (11.1%) in age- and sex-matched SLE controls using fixed cell-based assays (P =0.114). However, GABABR antibodies were not replicated using a live cell-based assay. NMDAR-antibodies were not detected with fixed or live cell assays in any samples.

Conclusion

Lupus psychosis is rare but treatable. In this rare sample of eighteen patients from a 40-year cohort, no significant biomarker was found, but some preliminary associations warrant further exploration in a larger multicentre analysis.
Discourses of Gender and Political Violence in South Africa
Authors: Cornell Josephine , Malherbe Nick , Seedat Mohamed , Suffla Shahnaaz
Published: February 2021

Politically violent women are regularly muted or made exceptional. Yet, underplaying women’s involvement in political violence obscures the systemic nature of such violence. We employ a discursive psychology analysis of an in-depth interview with a South African woman who has been involved in decades of political activism, and identified two discourses: Gendering Politically Violent Symbols and Enactments, where political violence was wielded as a symbol, and Gendering Political Organizing, wherein feminist agencies were directed against political structures. Together, these discourses indicate how gender identity is simultaneously consistent and at odds with political identity and how gender intersects with political violence.
Meta-analysis of the operative treatment of lumbar disc herniation via transforaminal percutaneous endoscopic discectomy versus interlaminar percutaneous endoscopic discectomy in randomized trials
Authors: He Ding-Wen , Xu Yan-Jie , Chen Wei-Cai , Miao Xin-Xin , Wu Hui , Wu Tian-Long , Jia Jing-Yu , Cheng Xi-Gao
Published: February 2021

Backgrounds:

Transforaminal percutaneous endoscopic discectomy (TF-PELD) and interlaminar percutaneous endoscopic discectomy (IL-PELD) are the most common alternative treatments of lumbar disc herniation. The aim of this study was to compare the operation time duration and X-ray exposure as well as outcomes of TF-PELD and IL-PELD as indicated by the published clinical evidences within randomized trials.

Methods:

We included randomized, controlled studies reporting operation duration and X-ray exposure as well as clinical outcome evaluations, comparing TF-PELD to IL-PELD with a minimum of 10 patients per group. The included data measures were operation duration, X-ray exposure and postoperation evaluations. Data were synthesized and analyzed using ReviewManager version 5.3. Publication bias was evaluated via funnel plot. The Cochran Q test and the degree of inconsistency (I
2) were used to assess heterogeneity. Lowly biased and heterogenous dichotomous data were calculated by odds ratio and continuous data were calculated by mean difference (MD) with 95% confidence intervals (CI).

Results:

Thirteen studies published from January 1970 to March 2018, with a total of 770 lumbar disc herniation patients, including 361 cases of TF-PELD and 409 cases of IL-PELD, were finally included. Meta-analysis of data extracted from these studies revealed that the postoperation outcomes of both surgery methods did not differ significantly, but the surgery duration was significantly shorter in the IL-PELD group than in the TF-PELD group (MD 21.69; 95% CI 12.94–30.27; P = .00001), and the fluoroscopy times demanded in the IL-PELD group was significantly fewer than those in the TF-PELD group (MD 7.57; 95% CI 6.22–8.93; P = .00001).

Conclusion:

The main finding of the study is that IL-PELD approach can decrease radiation exposure as their demanded duration of operation and fluoroscopy times were significantly shorter and fewer in the IL-PELD group, which they achieve similar outcomes comparing to TF-PELD. The study is limited at a lack of samples with lumbar disc herniation levels out of L5/S1. The findings implicate selection of IL-PELD approach over TF-PELD at applicable circumstances for lower lumbar disc herniation. Physicians should consider this data when choosing between TF-PELD and IL-PELD.
Screening of potential biomarkers for distinguishing between latent and active tuberculosis in children using bioinformatics analysis
Authors: Shao Meng , Wu Fang , Zhang Jie , Dong Jiangtao , Zhang Hui , Liu Xiaoling , Liang Su , Wu Jiangdong , Zhang Le , Zhang Chunjun , Zhang Wanjiang
Published: February 2021

Tuberculosis (TB) is one of the leading causes of childhood morbidity and death globally. Lack of rapid, effective non-sputum diagnosis and prediction methods for TB in children are some of the challenges currently faced. In recent years, blood transcriptional profiling has provided a fresh perspective on the diagnosis and predicting the progression of tuberculosis. Meanwhile, combined with bioinformatics analysis can help to identify the differentially expressed genes (DEGs) and functional pathways involved in the different clinical stages of TB. Therefore, this study investigated potential diagnostic markers for use in distinguishing between latent tuberculosis infection (LTBI) and active TB using children's blood transcriptome data.

From the Gene Expression Omnibus database, we downloaded two gene expression profile datasets (GSE39939 and GSE39940) of whole blood-derived RNA sequencing samples, reflecting transcriptional signatures between latent and active tuberculosis in children. GEO2R tool was used to screen for DEGs in LTBI and active TB in children. Database for Annotation, Visualization and Integrated Discovery tools were used to perform Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analysis. STRING and Cytoscape analyzed the protein-protein interaction network and the top 15 hub genes respectively. Receiver operating characteristics curve was used to estimate the diagnostic value of the hub genes.

A total of 265 DEGs were identified, including 79 upregulated and 186 downregulated DEGs. Further, 15 core genes were picked and enrichment analysis revealed that they were highly correlated with neutrophil activation and degranulation, neutrophil-mediated immunity and in defense response. Among them TLR2, FPR2, MMP9, MPO, CEACAM8, ELANE, FCGR1A, SELP, ARG1, GNG10, HP, LCN2, LTF, ADCY3 had significant discriminatory power between LTBI and active TB, with area under the curves of 0.84, 0.84, 0.84, 0.80, 0.87, 0.78, 0.88, 0.84, 0.86, 0.82, 0.85, 0.85, 0.79, and 0.88 respectively.

Our research provided several genes with high potential to be candidate gene markers for developing non-sputum diagnostic tools for childhood Tuberculosis.
Effect of acupoint catgut embedding in chronic fatigue syndrome patients
Authors: Zhang Mei-Lin , Fu Hong-Juan , Tang Yong , Luo Zhen-Guo , Li Jian-Yong , Li Rui
Published: February 2021

Background:

Chronic fatigue syndrome (CFS) is a relatively complex and disabling illness with a substantial economic burden and functional impairment. Until now, many CFS patients lack appropriate healthcare. Acupoint catgut embedding is an effective and emerging alternative therapy for CFE. With this research, we endeavor to investigate the effect and safety of ACE for CFS.

Methods:

Eight databases will be searched from inception to December 2020: PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chong-Qing VIP database, and Wan-fang database. We regard studies as eligible for inclusion if they were RCTs done in CFS patients, compare acupoint catgut embedding to another treatment strategy, and report fatigue changes at the end of the intervention period. Two independent reviewers complete the study selection, data extraction, and the risk of bias assessment. We assess pooled data using a random-effects model through Revman software (v.5.3) and Stata (version 15.0).

Ethics and dissemination:

Ethics approval is not required because the individual patient data will not be involved, with no privacy concerns. This systematic review and meta-analysis will provide a reference for CFS patients and clinicians on the non-drug interventions. We will publish and disseminate the results of this review in a peer-reviewed journal or relevant conference.

OSF Registration number:

10.17605/OSF.IO/7SHD9 (https://osf.io/7shd9).
Long-term effects of regular exercise during pregnancy on overweight and obese gravidas
Authors: Zhang Ying , Yang Yi , Xiong Guoping , Yu Fen
Published: February 2021

Background:

Overweight before pregnancy is independent risk factor for diabetes mellitus. This randomized controlled trial was to investigate the long-term effects of regular exercise during pregnancy on overweight and obese gravidas.

Methods and analysis:

This single-center, prospective, randomized controlled test will be conducted in Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology. Overweight and obese pregnant women will be included in our study and randomized into 2 groups: regular exercise and control groups. The informed consent will be acquired in each patient. Body weight, body fat, fasting and 2 h glucose level in 75 g oral glucose tolerance test (OGTT), insulin resistance index, and lipid profiles were compared. We also evaluated their physical activities with International Physical Activity Questionnaire (IPAQ), their dietary habits with modified Adult Dietary Behavior Assessment Scale, and depression condition with Postpartum Depression Screen Scale (PDSS). The significance level was defaulted as P < .05.

Results:

Results will be published in relevant peer-reviewed journals.

Conclusion:

Our study aims to systematically assess the effects of regular exercise for overweight and obese gravidas, which will be provided clinical guidance for overweight and obese gravidas.
Peripheral T lymphocytes predict the severity and prognosis in patients with HBV-related acute-on-chronic liver failure
Authors: Wang Feixia , Sun Weiwei , Xiao Qian , Liang Chongfeng , Jiang Shulian , Lian Yanan , Shao Jiangjuan , Tan Shanzhong , Zheng Shizhong
Published: February 2021

Background:

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening syndrome with high mortality. Biomarkers are urgently needed to predict the prognosis of HBV-ACLF. Recent evidence suggests a key role for immune system in the pathology of HBV-ACLF. Here, we analyzed the correlation between peripheral blood T lymphocytes and the severity and prognosis in HBV-ACLF patients.

Method:

Sixty-six patients with HBV-ACLF received conventional medical treatments for 4 weeks. Twenty-five healthy subjects and 20 HBV patients were enrolled for comparison. We determined white blood cell count, lymphocytes, CD3+, CD4+ and CD8+ T cells, and CD4+CD25+ Treg cells in the blood of all subjects. Their associations with laboratory parameters before or after treatments were statistically analyzed.

Result:

The results showed that compare normal subjects and chronic hepatitis B patients, HBV-ACLF patients had significantly increased white blood count, CD4+ T cells and decreased lymphocytes, CD3+ T cells, and Treg cells. Correlation analysis showed that white blood cell, lymphocytes, and peripheral T lymphocytes were correlated with prothrombin activity (PTA) and model for end-stage liver disease (MELD) scores. After treatment, white blood cell, lymphocytes, and peripheral T lymphocytes were also correlated with PTA and MELD scores. Additionally, total bilirubin (TBIL), alanine aminotransferase (ALT), international standard ratio (INR), MELD, and white blood cell count were potential prognostic criteria for HBV-ACLF patients.

Conclusion:

HBV-ACLF patients had depletion and dysfunction of immune system. Changes of peripheral T lymphocytes were closely related to the pathogenesis and prognosis of disease. Our results may contribute to predict the severity of HBV-ACLF, and provide a prognosis response to improve the treatment of HBV-ACLF.
The efficacy and safety of Xuebijing injection in the treatment of radiation pneumonitis
Authors: Li Zheng , Wang Dandan , Zhang Ying , Wang Shuo , Wang Xueqian , Li Yuxiao , Gui Yuerong , Dong Jun , Hou Wei
Published: February 2021

Background:

At present, the treatment of radiation pneumonitis (RP) is still a clinical problem. Although a variety of drugs such as glucocorticoids and antibiotics are used for RP treatment, side effects remain to be inevitable. Xuebijing injection (XBJ), a Chinese herbal injection, has been widely used in RP treatment, but there is no published systematic review to evaluate its efficacy and safety.

Methods:

Based on Preferred Reported Items for Systematic Review and Meta-analysis guidelines, we will conduct this systematic review and meta-analysis. Related randomized controlled trials will be searched in 7 databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, WANFANG database, SinoMED, and China Science and Technology Journal Database from inception of the library to October 1, 2020. Two researchers will independently carry out literature screening, data extraction, and bias risk assessment. The primary outcome is total effective rate and the secondary outcome is inflammation-related indicators such as C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, etc and adverse events. Cochrane Review Manager (RevMan 5.3) software will be applied to analyze the data and generate forest plot and funnel plot.

Results:

This study will provide a synthesis of current evidence of XBJ in RP treatment including total effective rate and inflammation-related indicators such as CRP, TNF-α, IL-6, IL-10, etc. and adverse events (AEs).

Conclusion:

This systematic review and meta-analysis will objectively evaluate the efficacy and safety of XBJ in the treatment of RP, and provide evidence for the application of XBJ in RP treatment.

Systematic review registration number:

INPLASY2020120037
Malignant adenomyoepithelioma of the breast
Authors: Zhang Zhihao , Wang Yueyuan , Xie Xiao , Peng Jingyu , Hong Jinghui , Bi Lirong , Yang Ming
Published: February 2021

Rationale:

Adenomyoepithelioma (AME) is a rare biphasic tumor consisting of epithelial and Myoepithelial cell. Most of the AME is benign, and only a few will progress to malignancy, Here, we report a case of low-grade malignant adenomyoepithelioma, and review the related literature, in a bid to investigate its clinical and pathological features and thus, enhance our understanding of this tumor.

Patient concerns:

A 64-year-old woman visited our hospital with a 1-year history of a painless mass in her left breast. Physical examination revealed a palpable painless mass, measuring approximately 4.5 cm, in the left breast.

Diagnosis:

Histological examination confirmed the diagnosis of malignant adenomyoepithelioma

Interventions:

The patient underwent local excision of the mass, with frozen section analysis revealing ductal carcinoma in situ. Mastectomy and sentinel lymph node biopsy were then performed.

Outcomes:

We conducted a one-year follow-up, and relapse was not observed.

Lessons:

Treatment of AME remains controversial owing to the lack of high volume data and absence of prospective studies. Simple mastectomy is an acceptable treatment of this tumor.
DAISY
Authors: Sweeney Cynthia Divens
Published: February 2021

The recent pandemic has caused many changes in the professional and personal lives of patients, their families, and the nurses who care for them. Something the pandemic could not change is the profound gratitude that patients, families, and others have for the extraordinary compassionate care that nurses have provided.
Nurse Leaders Employ Contemplative Practices to Promote Healthcare Professional Well-being and Decrease Anxiety
Authors: Cunningham Tim , Çayir Ebru
Published: February 2021

OBJECTIVE

The purpose of this study was to test the effectiveness of a daylong resilience retreat on healthcare professionals' anxiety levels, intention to engage in mindfulness practices, and self-efficacy around mindfulness.

BACKGROUND

Caregiver burnout is a concern that needs to be addressed at the organizational level so that professionals can reduce their risk of psychological injury while providing high-quality care. The COVID-19 (novel coronavirus) pandemic has exacerbated symptoms of burnout among nurses nationally.

METHODS

Ten sessions of daylong resilience retreats were delivered to independent groups of nurses, nurse practitioners, and other healthcare professionals. Preretreat and postretreat assessments were completed using a 19-item survey developed by the research team to assess state anxiety, intention to engage in mindfulness practices, and self-efficacy around mindfulness.

RESULTS

One hundred six healthcare professionals completed the resilience retreats. There was a statistically significant decrease in state anxiety scores following the retreat. The majority of the participants reported high intentions to engage in mindfulness practices and felt confident about incorporating mindfulness in their lives.

CONCLUSIONS

Brief resilience retreats endorsed by nurse leadership can reduce perceived anxiety and facilitate engagement in contemplative practices, which are associated with a decrease in the risk of burnout.
Leveraging Academic-Clinical Partnerships to Create an Operating Room Nurse Pipeline
Authors: Brooks Christopher , Della Ratta Carol , LaSala Mary Ellen , Gerberich Beverly , Browne Kevin
Published: February 2021

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®– and National Cancer Institute–designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.
Critical Care Nursing
Authors: Kurth Ann , Pinker Edieal , Martinello Richard A. , Honan Linda , Choi Steven , Beckman Beth
Published: February 2021

This article discusses the crucial role and dearth of critical care nurses in the United States highlighted during the COVID-19 pandemic. This challenge of sufficient critical care nursing resources existed before the pandemic, but now concern is heightened by the need for such crucial healthcare providers now and in the future. We present strategies to address the gap, as well as challenges inherent in the suggested approaches. The discussion is relevant as nurse leaders adapt to COVID-19 and other novel challenges in the future.
Neobacillus endophyticus sp. nov., an endophytic bacterium isolated from Selaginella involvens roots
Authors: Jiang Lingmin , Lee Myoung Hui , Jeong Jae Cheol , Kim Dae-Hyuk , Kim Cha Young , Kim Suk Weon , Lee Jiyoung
Published: February 2021

A Gram-stain-positive, facultatively anaerobic, rod-shaped, endospore-forming, oxidase-positive, and catalase-negative strain designated as BRMEA1T was isolated from the surface-sterilized Selaginella involvens roots. Growth of strain BRMEA1T was found to occur at pH 6.0–8.0 (optimum, pH 7.0), 15–50 °C (optimum, 25–30 °C) and in the absence of NaCl. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain BRMEA1T formed a lineage within the genus

Neobacillus

(family

Bacillaceae

) and showed the highest sequence similarity to

Neobacillus drentensis

DSM 15600T (98.3 %) and

Neobacillus fumarioli

KCTC 13885T (98.2 %), and less than 98.2 % 16S rRNA gene sequence similarity to the other members of the genus

Neobacillus

. Whole-genome analysis of strain BRMEA1T comprised a circular chromosome (5 632 809 bp in size) with 38.5 mol% G+C content. Digital DNA–DNA hybridization analyses revealed that strain BRMEA1T showed 20.5 and 22.0% genomic DNA relatedness with the closest species, N. drentensis DSM 15600T and

N. fumarioli

KCTC 13885T, respectively. The whole-genome sequence of strain BRMEA1T showed the presence of 11 specific conserved signature indels for the genus

Neobacillus

. The major cellular fatty acids (>10 %) of strain BRMEA1T were found to be iso-C15 : 0 and anteiso-C15 : 0, while the major polar lipids were found to be diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol. Polyphasic analysis results revealed that BRMEA1T represents a novel species of the genus

Neobacillus

, with the proposed name Neobacillus endophyticus sp. nov. The type strain is BRMEA1T (=KCTC 43208T=CCTCC AB 2020071T).
Pseudomonas kielensis sp. nov. and Pseudomonas baltica sp. nov., isolated from raw milk in Germany
Authors: Gieschler Stefanie , Fiedler Gregor , Böhnlein Christina , Grimmler Christina , Franz Charles M. A. P. , Kabisch Jan
Published: February 2021

In this study, nine Gram-negative, motile and rod-shaped bacteria were isolated during a Germany-wide investigation of raw milk microbiota. The strains could be differentiated from their closest relatives by phenotypic and chemotaxonomic characterization and average nucleotide identity (ANIb) values calculated from draft genome assemblies. Strains MBT-1T, MBT-8, MBT-9, MBT-10, MBT-11 and MBT-12 were related to the

Pseudomonas chlororaphis

subgroup. Isolates MBT-2T, MBT-13 and MBT-14 were closely related to

Pseudomonas rhizosphaerae

DSM 16299T with an ANIb of 88.2 % and a genome-to-genome distance result of 36.0 %. The G+C content of the DNA of strains MBT-1T and MBT-2T was 60.84 and 62.48 mol%, respectively. The major fatty acids were C16 : 1 ω7c (summed feature 3), C16 : 0 and C18 : 1 ω7c (summed feature 8). The strains were catalase-positive, while production of urease, β-galactosidase and indole were negative. Growth occurred at 4–30 °C and at pH values of pH 6.0–8.0. Based on these results, we conclude that the strains belong to two novel species, for which the names Pseudomonas kielensis sp. nov. and Pseudomonas baltica sp. nov. are proposed. The type strains are MBT-1T (=DSM 111668 T= LMG 31954T) and MBT-2T (=DSM 111761 T=LMG 31955T).
Lockdown benefit varies among countries and sub-national units: a reanalysis of the data by Bendavid et al. (2021)
Authors: Boesch Lukas
Published: February 2021

Are the lockdown measures limiting the propagation of COVID-19? Recent analyses on the effectiveness of non-pharmaceutical interventions in reducing COVID-19 growth rates delivered conflicting conclusions. While Haug et al. (2020) did find strong empirical support for reductions in COVID-19 growth rates, Bendavid et al. (2021) did not. Here, I present the results of a reanalysis of the data by Bendavid et al. (2021). Instead of relying on pairwise comparisons between 10 countries with fixed-effects regression models to isolate the effect of lockdown measures, I modelled the development of the pandemic with and without lockdown measures for the entire period and all countries included in the data with one mixed-effects regression model. My results reconciled the conflicting conclusions of Haug et al. (2020) and Bendavid et al. (2021): while mandatory business closure orders did not affect COVID-19 growth rates, a general decrease in COVID-19 growth rates was attributable to the implementation of mandatory stay-at-home orders. However, the effect of mandatory stay-at-home orders varied, being weaker, even zero, in some countries and sub-national units and stronger in others, where COVID-19 growth rates only decreased due to the implementation of mandatory stay-at-home orders. The heterogeneity in the effect of mandatory stay-at-home orders on the spread of COVID-19 is challenging from a scientific and political point of view.
REACT-1 round 9 interim report: downward trend of SARS-CoV-2 in England in February 2021 but still at high prevalence
Authors: Riley Steven , Walters Caroline E. , Wang Haowei , Eales Oliver , Haw David , Ainslie Kylie E. C. , Atchison Christina , Fronterre Claudio , Diggle Peter J. , Ashby Deborah , Donnelly Christl A. , Cooke Graham , Barclay Wendy , Ward Helen , Darzi Ara , Elliott Paul
Published: February 2021

Background and Methods

England entered its third national lockdown of the COVID-19 pandemic on 6th January 2021 with the aim of reducing the daily number of deaths and pressure on healthcare services. The real-time assessment of community transmission study (REACT-1) obtains throat and nose swabs from randomly selected people in England in order to describe patterns of SARS-CoV-2 prevalence. Here, we report data from round 9a of REACT-1 for swabs collected between 4th and 13th February 2021.

Results

Out of 85,473 tested-swabs, 378 were positive. Overall weighted prevalence of infection in the community in England was 0.51%, a fall of more than two thirds since our last report (round 8) in January 2021 when 1.57% of people tested positive. We estimate a halving time of 14.6 days and a reproduction number R of 0.72, based on the difference in prevalence between the end of round 8 and the beginning of round 9. Although prevalence fell in all nine regions of England over the same period, there was greater uncertainty in the trend for North West, North East, and Yorkshire and The Humber. Prevalence fell substantially across all age groups with highest prevalence among 18- to 24-year olds at 0.89% (0.47%, 1.67%) and those aged 5 to12 years at 0.86% (0.60%, 1.24%). Large household size, living in a deprived neighbourhood, and Asian ethnicity were all associated with increased prevalence. Healthcare and care home workers were more likely to test positive compared to other workers.

Conclusions

There is a strong decline in prevalence of SARS-CoV-2 in England among the general population five to six weeks into lockdown, but prevalence remains high: at levels similar to those observed in late September 2020. Also, the number of COVID-19 cases in hospitals is higher than at the peak of the first wave in April 2020. The effects of easing of social distancing when we transition out of lockdown need to be closely monitored to avoid a resurgence in infections and renewed pressure on health services.
Efficacy and safety of Ivermectin and Hydroxychloroquine in patients with severe COVID-19. A randomized controlled trial
Authors: Gonzalez Jose Lenin Beltran , González Gámez Mario , Enciso Emanuel Antonio Mendoza , Maldonado Ramiro Josue Esparza , Hernández Palacios Daniel , Dueñas Campos Samuel , Robles Itzel Ovalle , Macías Guzmán Mariana Jocelyn , García Díaz Andrea Lucia , Gutiérrez Peña César Mauricio , Medina Lucila Martinez , Colin Victor Antonio Monroy , Manuel Arreola Guerra Jose
Published: February 2021

Background

In the search for active drugs against COVID-19, the indications of many have been redirected. Ivermectin and Hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers.

Objectives

This clinical trial analyzes the efficacy of Ivermectin and Hydroxychloroquine in patients with moderate COVID-19 and in need of hospitalization.

Methods

This a controlled, clinical, randomized, double-blind trial that included patients with COVID-19-induced pneumonia and hospitalization criteria, but no severe respiratory failure. Patients were randomized to one of three groups: Group1-hydroxychloroquine, 400 mg every 12 hours on the first day and subsequently, 200 mg every 12 hours for 4 days, Group 2-ivermectin, 12 mg or 18 mg, according to patient weight and, Group 3-placebo. At inclusion, blood samples for arterial blood gases and biochemical markers associated with a poor prognosis were obtained. The primary outcome was established as the duration of hospitalization until discharge due to patient improvement, the total duration of hospitalization, and the safety outcomes were either respiratory deterioration or death.

Results

During the month of August, the admission of patients requiring hospitalization mostly encompassed cases with severe respiratory failure, so we ended the recruitment process and analyzed the data that was available at the time. One hundred and six (106) patients with an average age of 53 yrs. (±16.9) were included, with a greater proportion of males (n=66, 62.2 %). Seventy-two percent (72%) (n= 76) had an associated comorbidity. Ninety percent (90 %) of patients were discharged due to improvement (n=96). The average duration of hospitalization was 6 days (IQR, 3 – 10). No difference in hospitalization duration was found between the treatment groups (Group1: 7 vs Group 2: 6 vs Group 3: 5, p=0.43) nor in respiratory deterioration or death (Group 1: 18 % vs Group 2: 22.2 % vs Group 3: 24.3 %, p =0.83).

Conclusions

In non-critical hospitalized patients with COVID-19 pneumonia, neither ivermectin nor hydroxychloroquine decreases the number of in-hospital days, respiratory deterioration, or deaths.

ClinicalTrials identifier NCT04391127
Cohort profile: 10K - a large-scale prospective longitudinal study in Israel
Authors: Shilo Smadar , Bar Noam , Keshet Ayya , Talmor-Barkan Yeela , Rossman Hagai , Godneva Anastasia , Aviv Yaron , Edlitz Yochai , Reicher Lee , Kolobkov Dmitry , Wolf Bat Chen , Lotan-Pompan Maya , Levi Kohava , Cohen Ori , Saranga Hila , Weinberger Adina , Segal Eran
Published: February 2021

The 10K is a large-scale prospective longitudinal cohort and biobank that was established in Israel. The primary aims of the study include development of prediction models for disease onset and progression and identification of novel molecular markers with a diagnostic, prognostic and therapeutic value. The recruitment was initiated in 2018 and is expected to complete in 2021. Between 28/01/2019 and 13/12/2020, 4,629 from the expected 10,000 participants were recruited (46%). Follow-up visits are scheduled every year for a total of 25 years. The cohort includes individuals between the age of 40 and 70 years old. Predefined medical conditions were determined as exclusions. Information collected at baseline includes medical history, lifestyle and nutritional habits, vital signs, anthropometrics, blood tests results, Electrocardiography (ECG), Ankle–brachial pressure index (ABI), liver US and Dual-energy X-ray absorptiometry (DXA) tests. Molecular profiling includes transcriptome, proteome, gut and oral microbiome, metabolome and immune system profiling. Continuous measurements include glucose levels using a continuous glucose monitoring (CGM) device for 2 weeks and sleep monitoring by a home sleep apnea test (HSAT) device for 3 nights. Blood and stool samples are collected and stored at −80 °C in a storage facility for future research. Linkage is being established with national disease registries.
Differential effects of brain maintenance and cognitive reserve on age-related cognitive decline
Authors: Gazes Yunglin , Lee Seonjoo , Fang Zhiqian , Mensing Ashley , Noofoory Diala , Nazario Geneva Hidalgo , Babukutty Reshma , Chen Bryan , Habeck Christian , Stern Yaakov
Published: February 2021

Age-related cognitive changes can be influenced by both brain maintenance (BM), which refers to the relative absence over time of changes in neural resources or neuropathologic changes, and cognitive reserve (CR), which encompasses brain processes that allow for better-than-expected behavioral performance given the degree of life-course related brain changes. This study evaluated the effects of age, BM, and CR on longitudinal changes over two visits, 5 years apart, in four reference cognitive abilities that capture most of age-related variability. Participants included 254 healthy adults aged 20–80 years at recruitment. Potential BM was estimated using whole brain cortical thickness and white matter mean diffusivity at both visits. Education and IQ (estimated with AMNART) were tested as moderating factors for cognitive changes in the four reference abilities. Consistent with BM, after accounting for age, sex, and baseline performance, individual differences in the preservation of mean diffusivity were associated with relative preservation in the four abilities; differential preservation of cortical thickness was associated with preservation of reasoning, processing speed, and memory. Consistent with CR, after accounting for structural brain changes, higher IQ, but not education, was associated with reduced 5-year decline in reasoning. A similar marginal association was seen for memory but not for processing speed. These results demonstrate that both CR and BM can moderate cognitive changes in healthy aging and that the two mechanisms can make differential contributions to preserved cognition.

Significance

The theoretical constructs of brain maintenance (BM) and cognitive reserve (CR) are postulated to account for individual differences in age-related cognitive decline. To further understand BM and CR mechanisms, this study used a lifespan sample to examine 5-year changes in four cognitive abilities that comprehensively capture cognitive aging. Education has been the most used life exposure when studying CR, but recent studies suggest that education does not moderate age-related changes in brain and cognition in healthy aging so IQ was also considered. The results demonstrated that BM and CR can both exert unique influences on the same cognitive ability and that the two mechanisms differentially moderate change in the four reference abilities.
Temporal and geographical variation of COVID-19 in-hospital fatality rate in Brazil
Authors: Portella Tatiana Pineda , Mortara Sara Ribeiro , Lopes Rafael , Sánchez-Tapia Andrea , Donalísio Maria Rita , Castro Marcia C. , Venturieri Vito Ribeiro , Estevam Camila Genaro , Ribeiro Ana Freitas , Coutinho Renato Mendes , Sousa Mascena Veras Maria Amélia de , Inácio Prado Paulo , André Kraenkel Roberto
Published: February 2021

Background

Previous studies have shown that COVID-19 In-Hospital Fatality Rate (IHFR) varies between regions and has been diminishing over time. It is believed that the continuous improvement in the treatment of patients, age group of hospitalized, and the availability of hospital resources might be affecting the temporal and regional variation of IHFR. In this study, we explored how the IHFR varied over time and among age groups and federative states in Brazil. In addition, we also assessed the relationship between hospital structure availability and peaks of IHFR.

Methods

A retrospective analysis of all COVID-19 hospitalizations with confirmed outcomes in 22 states between March 01 and September 22, 2020 (n=345,281) was done. We fit GLM binomial models with additive and interaction effects between age groups, epidemiological weeks, and states. We also evaluated the association between the modeled peak of IHFR in each state and the variables of hospital structure using the Spearman rank correlation test.

Results

We found that the temporal variation of the IHFR was heterogeneous among the states, and in general it followed the temporal trends in hospitalizations. In addition, the peak of IHFR was higher in states with a smaller number of doctors and intensivists, and in states in which a higher percentage of people relied on the Public Health System (SUS) for medical care.

Conclusions

Our results suggest that the pressure over the healthcare system is affecting the temporal trends of IHFR in Brazil.

Key Messages

Temporal variation of age adjusted In-Hospital Fatality Rate (IHFR) was markedly heterogeneous among Brazilian states from March to September of 2020.

In several states, the IHFR increased in association with the increase in the number of hospitalizations, which suggests that the overload of the healthcare system might be affecting the temporal trends of IHFR in Brazil.

The IHFR remained low in the states with higher rates of hospital resources, even with the high demand for hospitalization.

The number of doctors and intensivist physicians per habitant was more strongly correlated with the peak of IHFR in the Brazilian states than the number of ICU beds.
The U-shaped association of serum iron level with disease severity in adult hospitalized patients with COVID-19
Authors: Tojo Kentaro , Sugawara Yoh , Oi Yasufumi , Ogawa Fumihiro , Higurashi Takuma , Yoshimura Yukihiro , Miyata Nobuyuki , Hayami Hajime , Yamaguchi Yoshikazu , Ishikawa Yoko , Takeuchi Ichiro , Tachikawa Natsuo , Goto Takahisa
Published: February 2021

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.