bluuebunny/crossref_metadata_2025 huggingface dataset:
A Program to Reduce Stigma Toward Mental Illness and Promote Mental Health Literacy and Help-Seeking in National Collegiate Athletic Association Division I Student-Athletes
Authors: Chow Graig M. , Bird Matthew D. , Gabana Nicole T. , Cooper Brandon T. , Swanbrow Becker Martin A.
Published: July 2020

Student-athletes are susceptible to mental health problems that disrupt optimal functioning and well-being. Despite having many protective factors, student-athletes represent an at-risk subgroup of college students who experience mental health concerns due to the distress of balancing multiple obligations. However, many student-athletes underutilize psychological services. Stigma is the main barrier preventing student-athletes from seeking help, and mental health literacy (MHL) interventions addressing knowledge and beliefs about mental disorders have traditionally been used to destigmatize mental illness. This study investigated the impact of a 4-week program on stigma, MHL, and attitudes and intentions toward seeking help with 33 National Collegiate Athletic Association Division I student-athletes. The program was composed of four science-based interventions—MHL, empathy, counter stereotyping, and contact—delivered face-to-face within a group setting. MHL, attitudes toward seeking help, and intentions to seek counseling improved from preintervention to postintervention and to 1-month follow-up. Self-stigma was reduced from preintervention to postintervention.
Reliability and Criterion-Related Validity of the activPAL™ Accelerometer When Measuring Physical Activity and Sedentary Behavior in Adults With Lower Limb Absence
Authors: Deans Sarah , Kirk Alison , McGarry Anthony , Rowe David
Published: July 2020

Introduction: Accurate measurement of physical behavior in adults with lower limb absence is essential to report true patterns of physical behavior and the effectiveness of interventions. The effect of placing accelerometers on prostheses may also affect the reliability and validity.Purpose: To assess reliability and criterion-related validity of the activPAL for measuring incidental and purposeful stepping, and reclining and stepping time in adults with unilateral lower limb absence.Methods: 15 adults with unilateral lower limb absence completed simulated lifestyle activities in a laboratory setting that were retrospectively scored via video analysis. Objective data were obtained simultaneously from two activPAL monitors placed on the sound and prosthetic side. Data were analyzed using one-way intraclass correlation coefficients (ICC), pairedt-tests and Cohen’sd.Results: Reliability (prosthetic side vs. sound side) was poor for incidental steps (ICC = .05,d = 0.48) but acceptable for all other measures (ICC = .77–.88;d = .00–.18). Mean activPAL measures, although highly related to the criterion, underestimated, on average, stepping and time-related variables. Differences were large for all stepping variables (d = .38–.96).Conclusions: The activPAL is a reliable measurement tool in adults with lower limb absence when used in a laboratory setting. Placement of the monitor on the sound side limb is recommended for testing. The activPAL shows evidence of relative validity, but not absolute validity. Further evaluation is needed to assess whether similar evidence is found in free-living activity and sedentary contexts.
Clinical Assessment and Thickness Changes of the Oblique and Multifidus Muscles Using a Novel Screening Tool and Exercise Program: A Randomized Controlled Trial
Authors: Catania Brian , Ross Travis , Sandella Bradley , Bley Bradley , DiTrani Lobacz Andrea
Published: July 2020

Context: Training and assessment of the abdominal and trunk muscles are widely used in the clinical setting. However, it is unknown what types of exercises are most effective in activation of both the global and local stabilizers in these regions. Objective: The purpose of this study was to establish the reliability of a novel clinical screening tool (sling screen) to assess the muscles of the abdomen and trunk. The second aim was to use the clinical screening tool and musculoskeletal ultrasound to compare the effects of a rotary-based exercise program that targets both the global and local muscles to the effects of a traditional exercise program on the activation of the abdominal and trunk muscles. Design: Double-blind, randomized controlled trial. Setting: Sports medicine facility. Participants and Interventions: Thirty-one healthy participants were randomly allocated to receive a single-session rotary-based or traditional “core” exercise program. Main Outcome Measures: The participants were assessed at the baseline and immediately postintervention. The primary outcome measures were muscle thickness examined by musculoskeletal ultrasound and clinical examination of muscle activation using a screening tool. The data were collected by blind assessors. Reliability and validity of a clinical screening tool (sling screen) were also assessed. Results: The analysis of the covariance tests showed a significant increase in oblique thickness for the rotary exercise group. All participants displayed a significant increase in multifidus thickness. The Wilcoxon signed-rank tests revealed a significant increase in clinical assessment scores in the rotary exercise group but not the traditional exercise group. Reliability of the sling screen ranged from moderate to good. Conclusion: This clinical trial provides evidence that a rotary-based exercise program may be more effective in producing increases in oblique muscle thickness than traditional “core” exercises in young, healthy adults. The sling screen tool was able to identify these muscle thickness changes. Future studies should investigate how these results correlate to injury risk, other populations, and also how to implement the sling screen into clinical practice.
Zainichi Koreans Invited to Home Base: Building Ethnic Identity and Its Impact on the Development of Korean Baseball (1956–70)
Authors: Woo Seungho , Son Hwan , Lee Karam
Published: July 2020

Zainichi Koreans are a unique political product of the Korean Peninsula. They were taken to Japan under the Japanese occupation (1910–45) of Korea and stayed there without becoming naturalized Japanese citizens. Baseball was a mechanism for the children of Zainichi Koreans, who were oppressed on Japanese soil, to overcome the discrimination they were experiencing in their daily lives and assimilate into Japanese society. From 1956 to 1970, South Korean newspapers invited Zainichi Korean children playing baseball to their home country for regular national baseball exchanges. This event provided nourishment for the growth of Korean baseball and served as the only cultural bridge for Zainichi Korean children to experience and understand their motherland, which they had previously only imagined.
The mitophagy effector FUNDC1 controls mitochondrial reprogramming and cellular plasticity in cancer cells
Authors: Li Jie , Agarwal Ekta , Bertolini Irene , Seo Jae Ho , Caino M. Cecilia , Ghosh Jagadish C. , Kossenkov Andrew V. , Liu Qin , Tang Hsin-Yao , Goldman Aaron R. , Languino Lucia R. , Speicher David W. , Altieri Dario C.
Published: July 2020

FUNDC1 regulates mitochondrial morphology, localization, and function to support cancer cell proliferation.
Murine Cytomegalovirus M25 Proteins Sequester the Tumor Suppressor Protein p53 in Nuclear Accumulations
Authors: Kutle Ivana , Szymańska-de Wijs Katarzyna M. , Bogdanow Boris , Cuvalo Berislav , Steinbrück Lars , Jonjić Stipan , Wagner Karen , Niedenthal Rainer , Selbach Matthias , Wiebusch Lüder , Dezeljin Martina , Messerle Martin
Published: July 2020

Host cells use a number of factors to defend against viral infection. Viruses are, however, in an arms race with their host cells to overcome these defense mechanisms. The tumor suppressor protein p53 is an important sensor of cell stress induced by oncogenic insults or viral infections, which upon activation induces various pathways to ensure the integrity of cells. Viruses have to counteract many functions of p53, but complex DNA viruses such as cytomegaloviruses may also utilize some p53 functions for their own benefit. In this study, we discovered that the M25 proteins of mouse cytomegalovirus interact with p53 and mediate its accumulation during infection. Interaction with the M25 proteins sequesters p53 molecules in nuclear dot-like structures, limiting their availability for activation of a subset of p53-regulated target genes. Understanding the interaction between viral proteins and p53 may allow to develop new therapeutic strategies against cytomegalovirus and other viruses.
In Vitro
Quantification of the Effects of IP6 and Other Small Polyanions on Immature HIV-1 Particle Assembly and Core Stability
Authors: Dostálková Alžběta , Kaufman Filip , Křížová Ivana , Vokatá Barbora , Ruml Tomáš , Rumlová Michaela
Published: July 2020

Various host cell factors facilitate critical steps in the HIV-1 replication cycle. One of these factors is myo-inositol hexaphosphate (IP6), which contributes to assembly of HIV-1 immature particles and helps maintain the well-balanced metastability of the core in the mature infectious virus. Using a combination of two
in vitro
methods to monitor assembly of immature HIV-1 particles and disassembly of the mature core-like structure, we quantified the contribution of IP6 and other small polyanion molecules to these essential steps in the viral life cycle. Our data showed that IP6 contributes substantially to increasing the assembly of HIV-1 immature particles. Additionally, our analysis confirmed the important role of two HIV-1 capsid lysine residues involved in interactions with IP6. We found that myo-inositol hexasulphate also stabilized the HIV-1 mature particles in a concentration-dependent manner, indicating that targeting this group of small molecules may have therapeutic potential.
Supplemental Material: Precipitation and aridity constraints from paleolakes on early Mars
Authors: Stucky de Quay Gaia , al. et
Published: July 2020

Additional details on methods, sensitivity tests for results, Figures S1–S6, and Tables S1–S3.
Racial discrimination and socioemotional and sleep problems in a cross-sectional survey of Australian school students
Authors: Priest Naomi , Chong Shiau , Truong Mandy , Alam Oishee , Dunn Kevin , O'Connor Meredith , Paradies Yin , Ward Andrew , Kavanagh Anne
Published: July 2020

Objective

To determine the prevalence of direct and vicarious racial discrimination experiences from peer, school and societal sources, and examine associations between these experiences and socioemotional and sleep outcomes.

Methods

Data were analysed from a population representative cross-sectional study of n=4664 school students in years 5–9 (10–15 years of age) in Australia. Students reported direct experiences of racial discrimination from peers, school and societal sources; vicarious discrimination was measured according to the frequency of witnessing other students experiences of racial discrimination. Students self-reported on the Strengths and Difficulties Questionnaire, with the total difficulties, conduct, emotional and prosocial behaviour subscales examined. Sleep problems included duration, latency, and disruption.

Results

41.56% (95% CI 36.18 to 47.15) of students reported experiences of direct racial discrimination; Indigenous and ethnic minority students reported the highest levels. 70.15% (95% CI 63.83 to 75.78) of students reported vicarious racial discrimination. Direct and vicarious experiences of racial discrimination were associated with socioemotional adjustment (eg, for total difficulties, total direct racism: beta=3.77, 95% CI 3.11 to 4.44; vicarious racism: beta=2.51, 95% CI 2.00 to 3.03). Strong evidence was also found for an effect of direct and vicarious discrimination on sleep (eg, for sleep duration, total direct: beta=−21.04, 95% CI −37.67 to −4.40; vicarious: beta=−9.82, 95% CI −13.78 to −5.86).

Conclusions

Experiences of direct and vicarious racial discrimination are common for students from Indigenous and ethnic minority backgrounds, and are associated with socioemotional and sleep problems in adolescence. Racism and racial discrimination are critically important to tackle as social determinants of health for children and adolescents.
Long-term BMI change trajectories in Chinese adults and its association with the hazard of type 2 diabetes: evidence from a 20-year China Health and Nutrition Survey
Authors: Mi Baibing , Wu Chenlu , Gao Xiangyu , Wu Wentao , Du Jiaoyang , Zhao Yaling , Wang Duolao , Dang Shaonong , Yan Hong
Published: July 2020

Introduction

To investigate the relationship between long-term change trajectory in body mass index (BMI) and the hazard of type 2 diabetes among Chinese adults.

Research design and methods

Data were obtained from the China Health and Nutrition Survey (CHNS). Type 2 diabetes was reported by participants themselves in each survey wave. The duration of follow-up was defined as the period from the first visit to the first time self-reported type 2 diabetes, death, or other loss to follow-up from CHNS. The patterns of change trajectories in BMI were derived by latent class trajectory analysis method. The Fine and Gray regression model was used to estimate HRs with corresponding 95% CIs for type 2 diabetes.

Results

Four patterns of the trajectories of change in BMI were identified among Chinese adults, 42.7% of participants had stable BMI change, 40.8% for moderate BMI gain, 8.9% for substantial BMI gain and 7.7% for weight loss. During the follow-up with mean 11.2 years (158 637 person-years contributed by 14 185 participants), 498 people with type 2 diabetes (3.7%) occurred. Risk of type 2 diabetes was increased by 47% among people who gained BMI more substantially and rapidly (HR: 1.47, 95% CI 1.08 to 2.02, p=0.016) and increased by 20% among those in people with the moderate BMI gain (HR: 1.20, 95% CI 0.98 to 1.48, p=0.078), compared with those with stable BMI change.

Conclusions

Long-term substantial gain of BMI was significantly associated with an increased risk of type 2 diabetes in the Chinese adults.
HbA1c response and hospital admissions following commencement of flash glucose monitoring in adults with type 1 diabetes
Authors: Stimson Roland H , Dover Anna R , Ritchie Stuart A , Wright Rohana J , McKnight John A , Zammitt Nicola N , Gibb Fraser W
Published: July 2020

Introduction

Our aim was to assess the effect of introducing flash monitoring in adults with type 1 diabetes with respect to change in hemoglobin A1c (HbA1c) and frequency of hospital admissions.

Research design and methods

Prospective observational study of adults with type 1 diabetes in our center, in whom a prescription for a flash monitoring sensor was collected. Primary outcome was change in HbA1c between 2016 and after flash monitoring. Rates of hospital admission were compared between the first year after flash monitoring and the corresponding 12-month period 2 years earlier.

Results

Approximately half of all adults with type 1 diabetes, attending our center, collected prescriptions for flash monitoring sensors (n=2216). Median fall in HbA1c was −1 (−0.1) mmol/mol (%) (p<0.001) and was greatest in those with baseline HbA1c >75 (9.0) mmol/mol (%): −10 (−0.9) mmol/mol (%), p<0.001. 43% of those with a baseline HbA1c >53 mmol/mol (7%) experienced a ≥5 mmol/mol (0.5%) fall in HbA1c. In addition to higher HbA1c, early commencement within 1 month of NHS-funded flash monitoring (p<0.001), and male gender (p=0.013) were associated with a fall in HbA1c of ≥5 (0.5) mmol/mol (%). Socioeconomic deprivation (p=0.009) and collecting fewer than 2 sensors per month (p=0.002) were associated with lack of response. Overall, hospital admissions did not change but an increase in admissions for hypoglycemia was observed (1.1% vs 0.3%, p=0.026).

Conclusions

Flash monitoring is associated with reduction in HbA1c in individuals with HbA1c >58 mmol/mol. Numerous clinical features are independently associated with HbA1c response. An increase in hypoglycemia admissions occurred following flash monitoring.
Risk of lower gastrointestinal bleeding and colorectal neoplasms following initiation of low-dose aspirin: a Danish population-based cohort study
Authors: Troelsen Frederikke Schønfeldt , Farkas Dóra Körmendiné , Erichsen Rune , Sørensen Henrik Toft
Published: July 2020

Objective

Aspirin may increase the risk of lower gastrointestinal bleeding (LGIB) from precursors of colorectal cancer (CRC). We investigated whether use of low-dose aspirin, through initiation of LGIB, may lead patients to undergo colonoscopy and polypectomy before manifest CRC.

Design

We conducted a historical cohort study (2005–2013) of all Danish residents who initiated low-dose aspirin treatment (n=412 202) in a setting without screening for CRC. Each new aspirin user was matched with three non-users (n=1 236 560) by age, sex and region of residence on the date of their matched new user’s first-time aspirin prescription (index date). We computed absolute risks (ARs), risk differences and relative risks (RRs) of LGIB, lower gastrointestinal endoscopy, colorectal polyps and CRC, comparing aspirin users with non-users.

Results

The ARs were higher for new users than non-users for LGIB, lower gastrointestinal endoscopy, colorectal polyps and CRC within 3 months after index. Comparing new users with non-users, the RRs were 2.79 (95% CI 2.40 to 3.24) for LGIB, 1.73 (95% CI 1.63 to 1.84) for lower gastrointestinal endoscopy, 1.56 (95% CI 1.42 to 1.72) for colorectal polyps and 1.73 (95% CI 1.51 to 1.98) for CRC. The RRs remained elevated for more than 12 months after the index date, with the exception of CRC where the RRs were slightly decreased during the 3–5 years (RR 0.90, 95% CI 0.83 to 0.98) and more than 5 years (RR 0.91, 95% CI 0.82 to 1.00) following the index date.

Conclusion

These findings indicate that aspirin may contribute to reduce CRC risk by causing premalignant polyps to bleed, thereby expediting colonoscopy and polypectomy before CRC development.
Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis
Authors: Hung Yuen W , Law Michael R , Cheng Lucy , Abramowitz Sharon , Alcayna-Stevens Lys , Lurton Grégoire , Mayaka Serge Manitu , Olekhnovitch Romain , Kyomba Gabriel , Ruton Hinda , Ramazani Sylvain Yuma , Grépin Karen A
Published: July 2020

Background

During past outbreaks of Ebola virus disease (EVD) and other infectious diseases, health service utilisation declined among the general public, delaying health seeking behaviour and affecting population health. From May to July 2018, the Democratic Republic of Congo experienced an outbreak of EVD in Equateur province. The Ministry of Public Health introduced a free care policy (FCP) in both affected and neighbouring health zones. We evaluated the impact of this policy on health service utilisation.

Methods

Using monthly data from the national Health Management Information System from January 2017 to January 2019, we examined rates of the use of nine health services at primary health facilities: total visits; first and fourth antenatal care visits; institutional deliveries; postnatal care visits; diphtheria, pertussis and tetanus (DTP) vaccinations and visits for uncomplicated malaria, pneumonia and diarrhoea. We used controlled interrupted time series analysis with a mixed effects model to estimate changes in the rates of services use during the policy (June–September 2018) and afterwards.

Findings

Overall, use of most services increased compared to control health zones, including EVD affected areas. Total visits and visits for pneumonia and diarrhoea initially increased more than two-fold relative to the control areas (p<0.001), while institutional deliveries and first antenatal care increased between 20% and 50% (p<0.01). Visits for DTP, fourth antenatal care visits and postnatal care visits were not significantly affected. During the FCP period, visit rates followed a downward trend. Most increases did not persist after the policy ended.

Interpretation

The FCP was effective at rapidly increasing the use of some health services both EVD affected and not affected health zones, but this effect was not sustained post FCP. Such policies may mitigate the adverse impact of infectious disease outbreaks on population health.
The COVID-19 pandemic: diverse contexts; different epidemics—how and why?
Authors: Van Damme Wim , Dahake Ritwik , Delamou Alexandre , Ingelbeen Brecht , Wouters Edwin , Vanham Guido , van de Pas Remco , Dossou Jean-Paul , Ir Por , Abimbola Seye , Van der Borght Stefaan , Narayanan Devadasan , Bloom Gerald , Van Engelgem Ian , Ag Ahmed Mohamed Ali , Kiendrébéogo Joël Arthur , Verdonck Kristien , De Brouwere Vincent , Bello Kéfilath , Kloos Helmut , Aaby Peter , Kalk Andreas , Al-Awlaqi Sameh , Prashanth NS , Muyembe-Tamfum Jean-Jacques , Mbala Placide , Ahuka-Mundeke Steve , Assefa Yibeltal
Published: July 2020

It is very exceptional that a new disease becomes a true pandemic. Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. However, in different countries, the COVID-19 epidemic takes variable shapes and forms in how it affects communities. Until now, the insights gained on COVID-19 have been largely dominated by the COVID-19 epidemics and the lockdowns in China, Europe and the USA. But this variety of global trajectories is little described, analysed or understood. In only a few months, an enormous amount of scientific evidence on SARS-CoV-2 and COVID-19 has been uncovered (knowns). But important knowledge gaps remain (unknowns). Learning from the variety of ways the COVID-19 epidemic is unfolding across the globe can potentially contribute to solving the COVID-19 puzzle. This paper tries to make sense of this variability—by exploring the important role that context plays in these different COVID-19 epidemics; by comparing COVID-19 epidemics with other respiratory diseases, including other coronaviruses that circulate continuously; and by highlighting the critical unknowns and uncertainties that remain. These unknowns and uncertainties require a deeper understanding of the variable trajectories of COVID-19. Unravelling them will be important for discerning potential future scenarios, such as the first wave in virgin territories still untouched by COVID-19 and for future waves elsewhere.
Mobilising computable biomedical knowledge: challenges for clinical decision support from a medical knowledge provider
Authors: Walsh Kieran , Wroe Chris
Published: July 2020

Introduction

This paper summarises a talk given at the first UK workshop on mobilising computable biomedical knowledge on 29 October 2019 in London. It examines challenges in mobilising computable biomedical knowledge for clinical decision support from the perspective of a medical knowledge provider.

Methods

We developed the themes outlined below after personally reflecting on the challenges that we have encountered in this field and after considering the barriers that knowledge providers face in ensuring that their content is accessed and used by healthcare professionals. We further developed the themes after discussing them with delegates at the workshop and listening to their feedback.

Discussion

There are many challenges in mobilising computable knowledge for clinical decision support from the perspective of a medical knowledge provider. These include the size of the task at hand, the challenge of creating machine interpretable content, the issue of standards, the need to do better in tracing how computable medical knowledge that is part of clinical decision support impacts patient outcomes, the challenge of comorbidities, the problem of adhering to safety standards and finally the challenge of integrating knowledge with problem solving and procedural skills, healthy attitudes and professional behaviours. Partnership is likely to be essential if we are to make progress in this field. The problems are too complex and interrelated to be solved by any one institution alone.
HDR UK supporting mobilising computable biomedical knowledge in the UK
Authors: Sebire Neil J , Cake Caroline , Morris Andrew D
Published: July 2020

Computable biomedical knowledge (CBK) represents an evolving area of health informatics, with potential for rapid translational patient benefit. Health Data Research UK (HDR UK) is the national Institute for Health Data Science, whose aim is to unite the UK’s health data to enable discoveries that improve people’s lives. The three main components include the UK HDR Alliance of data custodians, committed to making health data available for research and innovation purposes for public benefit while ensuring safe use of data and building public trust, the HDR Hubs, as centres of expertise for curating data and providing expert domain-specific services, and the HDR Innovation Gateway (‘Gateway’), providing discovery, accessibility, security and interoperability services. To support CBK developments, HDR UK is encouraging use of open data standards for research purposes, with guidance around areas in which standards are emerging, aims to work closely with the international CBK community to support initiatives and aid with evaluation and collaboration, and has established a phenomics workstream to create a national platform for dissemination of machine readable and computable phenotypical algorithms to reduce duplication of effort and improve reproducibility in clinical studies.
OpenClinical.net: Artificial intelligence and knowledge engineering at the point of care
Authors: Fox John , South Matthew , Khan Omar , Kennedy Catriona , Ashby Peter , Bechtel John
Published: July 2020

Objective

OpenClinical.net is a way of disseminating clinical guidelines to improve quality of care whose distinctive feature is to combine the benefits of clinical guidelines and other human-readable material with the power of artificial intelligence to give patient-specific recommendations. A key objective is to empower healthcare professionals to author, share, critique, trial and revise these ‘executable’ models of best practice.

Design

OpenClinical.netAlpha(www.openclinical.net) is an operational publishing platform that uses a class of artificial intelligence techniques calledknowledge engineeringto capture human expertise in decision-making, care planning and other cognitive skills in an intuitive but formal language called PROforma.3 PROformamodels can be executed by a computer to yield patient-specific recommendations, explain the reasons and provide supporting evidence on demand.

Results

PROformahas been validated in a wide range of applications in diverse clinical settings and specialties, with trials published in high impact peer-reviewed journals. Trials have included patient workup and risk assessment; decision support (eg, diagnosis, test and treatment selection, prescribing); adaptive care pathways and care planning. The OpenClinical software platform presently supports authoring, testing, sharing and maintenance. OpenClinical’s open-access, open-source repositoryRepertoirecurrently carries approximately 50+ diverse examples (https://openclinical.net/index.php?id=69).

Conclusion

OpenClinical.net is a showcase for a PROforma-based approach to improving care quality, safety, efficiency and better patient experience in many kinds of routine clinical practice. This human-centred approach to artificial intelligence will help to ensure that it is developed and used responsibly and in ways that are consistent with professional priorities and public expectations.
Multimodality imaging assessment of mitral annular disjunction in mitral valve prolapse
Authors: Mantegazza Valentina , Volpato Valentina , Gripari Paola , Ghulam Ali Sarah , Fusini Laura , Italiano Gianpiero , Muratori Manuela , Pontone Gianluca , Tamborini Gloria , Pepi Mauro
Published: July 2020

Objective

Mitral annular disjunction (MAD) is an abnormality linked to mitral valve prolapse (MVP), possibly associated with malignant ventricular arrhythmias. We assessed the agreement among different imaging techniques for MAD identification and measurement.

Methods

131 patients with MVP and significant mitral regurgitation undergoing transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) were retrospectively enrolled. Transoesophageal echocardiography (TOE) was available in 106 patients. MAD was evaluated in standard long-axis views (four-chamber, two-chamber, three-chamber) by each technique.

Results

Considering any-length MAD, MAD prevalence was 17.3%, 25.5%, 42.0% by TTE, TOE and CMR, respectively (p<0.05). The agreement on MAD identification was moderate between TTE and CMR (κ=0.54, 95% CI 0.49 to 0.59) and good between TOE and CMR (κ=0.79, 95% CI 0.74 to 0.84). Assuming CMR as reference and according to different cut-off values for MAD (≥2 mm, ≥4 mm, ≥6 mm), specificity (95% CI) of TTE and TOE was 99.6 (99.0 to 100.0)% and 98.7 (97.4 to 100.0)%; 99.3 (98.4 to 100.0)% and 97.6 (95.8 to 99.4)%; 97.8 (96.2 to 99.3)% and 93.2 (90.3 to 96.1)%, respectively; sensitivity (95% CI) was 43.1 (37.8 to 48.4)% and 74.5 (69.4 to 79.5)%; 54.0 (48.7 to 59.3)% and 88.9 (85.2 to 92.5)%; 88.0 (84.5 to 91.5)% and 100.0 (100.0 to 100.0)%, respectively. MAD length was 8.0 (7.0-10.0), 7.0 (5.0-8.0], 5.0 (4.0-7.0) mm, respectively by TTE, TOE and CMR. Agreement on MAD measurement was moderate between TTE and CMR (ρ=0.73) and strong between TOE and CMR (ρ=0.86).

Conclusions

An integrated imaging approach could be necessary for a comprehensive assessment of patients with MVP and symptoms suggestive for arrhythmias. If echocardiography is fundamental for the anatomic and haemodynamic characterisation of the MV disease, CMR may better identify small length MAD as well as myocardial fibrosis.
Fatal pulmonary fibrosis: a post-COVID-19 autopsy case
Authors: Schwensen Hanna Ferløv , Borreschmidt Line Kristine , Storgaard Merete , Redsted Søren , Christensen Steffen , Madsen Line Bille
Published: July 2020

There is growing evidence of histopathological changes in autopsied individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, data on histopathological changes in autopsied patients with eradicated COVID-19 are limited. We performed an autopsy on a Caucasian female in her 80s, who died due to severe, bilateral pulmonary fibrosis after eliminated SARS-CoV-2 infection. In addition, CT scans from 2 months before infection and from 6 days prior to death were compared. Comparison of the CT scans showed bilateral development of widespread fibrosis in previously healthy lungs. Microscopic examination showed different areas with acute and organising diffuse alveolar damage and fibrosis with honeycomb-like remodelling and bronchial metaplasia. We here report a unique autopsy case with development of widespread pulmonary fibrosis in a woman in her 80s with previous COVID-19 and no history of pulmonary illnesses.
Prognostic value of novel immune-related genomic biomarkers identified in head and neck squamous cell carcinoma
Authors: Yao Yao , Yan Zhongyi , Lian Senlin , Wei Liangnian , Zhou Chao , Feng Dongju , Zhang Yuan , Yang Jianrong , Li Ming , Chen Yun
Published: July 2020

Background

The immune response within the tumor microenvironment plays a key role in tumorigenesis and determines the clinical outcomes of head and neck squamous cell carcinoma (HNSCC). However, to date, a paucity of robust, reliable immune-related biomarkers has been identified that are capable of estimating prognosis in HNSCC patients.

Methods

High-throughput RNA sequencing was performed in tumors and matched adjacent tissues from five HNSCC patients, and the immune signatures expression of 730 immune-related transcripts selected from the nCounter PanCancer Immune Profiling Panel were assessed. Survival analyzes were performed in a training cohort, consisting of 416 HNSCC cases, retrieved from The Cancer Genome Atlas (TCGA) database. A prognostic signature was built, using elastic net-penalized Cox regression and backward, stepwise Cox regression analyzes. The outcomes were validated by an independent cohort of 115 HNSCC patients, using tissue microarrays and immunohistochemistry staining. Cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) was also used to estimate the relative fractions of 22 immune-cell types and their correlations coefficients with prognostic biomarkers.

Results

Collectively, 248 immune-related genes were differentially expressed in paired tumors and normal tissues using RNA sequencing. After process screening in the training TCGA cohort, four immune-related genes (PVR, TNFRSF12A,IL21R, andSOCS1) were significantly associated with overall survival (OS). Integrating these genes with Path_N stage, a multiplex model was built and suggested better performance in determining 5 years OS (receiver operating characteristic (ROC) analysis, area under the curve (AUC)=0.709) than others. Further protein-based validation was conducted in 115 HNSCC patients. Similarly, high expression of PVR and TNFRSF12A were associated with poor OS (Kaplan-Meier p=0.017 and 0.0032), while high expression of IL21R and SOCS1 indicated favorable OS (Kaplan-Meier p<0.0001 and =0.0018). The integrated model with Path_N stage still demonstrated efficacy in OS evaluation (Kaplan-Meier p<0.0001, ROC AUC=0.893). Besides, the four prognostic genes were significantly correlated with activated CD8+T cells, CD4+T cells, follicular helper T cells and regulatory T cells, implying the possible involvement of these genes in the immunoregulation and development of HNSCC.

Conclusions

The well-established model encompassing both immune-related biomarkers and clinicopathological factor might serve as a promising tool for the prognostic prediction of HNSCC.
Cigarette smoking and risk of intracranial aneurysms in middle-aged women
Authors: Ogilvy Christopher S , Gomez-Paz Santiago , Kicielinski Kimberly P , Salem Mohamed M , Akamatsu Yosuke , Waqas Muhammad , Rai Hamid Hussain , Catapano Joshua S , Muram Sandeep , Elghareeb Mohammed , Siddiqui Adnan H , Levy Elad I , Lawton Michael T , Mitha Alim P , Hoh Brian L , Polifka Adam , Fox W Christopher , Moore Justin M , Thomas Ajith J
Published: July 2020

Background and purpose

We previously reported a single-centre study demonstrating that smoking confers a six-fold increased risk for having an unruptured intracranial aneurysm (UIA) in women aged between 30 and 60 years and this risk was higher if the patient had chronic hypertension. There are no data with greater generalisability evaluating this association. We aimed to validate our previous findings in women from a multicentre study.

Methods

A multicentre case-control study on women aged between 30 and 60 years, that had magnetic resonance angiography (MRA) during the period 2016–2018. Cases were those with an incidental UIA, and these were matched to controls based on age and ethnicity. A multivariable conditional logistic regression was conducted to evaluate smoking status and hypertension differences between cases and controls.

Results

From 545 eligible patients, 113 aneurysm patients were matched to 113 controls. The most common reason for imaging was due to chronic headaches in 62.5% of cases and 44.3% of controls. A positive smoking history was encountered in 57.5% of cases and in 37.2% of controls. A multivariable analysis demonstrated a significant association between positive smoking history (OR 3.7, 95%CI 1.61 to 8.50), hypertension (OR 3.16, 95% CI 1.17 to 8.52) and both factors combined with a diagnosis of an incidental UIA (OR 6.9, 95% CI 2.49 to 19.24).

Conclusions

Women aged between 30 and 60 years with a positive smoking history have a four-fold increased risk for having an UIA, and a seven-fold increased risk if they have underlying chronic hypertension. These findings indicate that women aged between 30 and 60 years with a positive smoking history might benefit from a screening recommendation.
Moral distress and moral residue experienced by transplant coordinators
Authors: Tarabeih Mahdi , Bokek-Cohen Ya'arit
Published: July 2020

Transplant coordinators play a pivotal role in the process of obtaining consent for live or dead donation of organs. The objective of the project is to unveil emotional experiences and ethical conduct of transplant coordinators using a qualitative research methodology. Ten transplant coordinators who have worked for more than 20 years in this job were recruited by using a purposive sampling technique. The transplant coordinators spoke of negative feelings and moral distress with regard to futile care of family members of deceased donors as well as of living donors. Transplant coordinators experience moral distress on a daily basis; being compelled to compromise their integrity causes moral distress and moral residue, hence, training and support should be offered to them.
Urine and serum S100A8/A9 and S100A12 associate with active lupus nephritis and may predict response to rituximab treatment
Authors: Davies Jennifer C , Midgley Angela , Carlsson Emil , Donohue Sean , Bruce Ian N , Beresford Michael W , Hedrich Christian M
Published: July 2020

Background

Approximately 30% of patients with the systemic autoimmune/inflammatory disorder systemic lupus erythematosus (SLE) develop lupus nephritis (LN) that affects treatment and prognosis. Easily accessible biomarkers do not exist to reliably predict renal disease. The Maximizing SLE Therapeutic Potential by Application of Novel and Systemic Approaches and the Engineering Consortium aims to identify indicators of treatment responses in SLE. This study tested the applicability of calcium-binding S100 proteins in serum and urine as biomarkers for disease activity and response to treatment with rituximab (RTX) in LN.

Methods

S100A8/A9 and S100A12 proteins were quantified in the serum and urine of 243 patients with SLE from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR) study and 48 controls matched for age using Meso Scale Discovery’s technology to determine whether they perform as biomarkers for active LN and/or may be used to predict response to treatment with RTX. Renal disease activity and response to treatment was based on BILAG-BR scores and changes in response to treatment.

Results

Serum S100A12 (p<0.001), and serum and urine S100A8/A9 (p<0.001) levels are elevated in patients with SLE. While serum and urine S100 levels do not correlate with global disease activity (SLE Disease Activity Index), levels in urine and urine/serum ratios are elevated in patients with active LN. S100 proteins perform better as biomarkers for active LN involvement in patients with SLE who tested positive for anti-double-stranded DNA antibodies. Binary logistic regression and area under the curve analyses suggest the combination of serum S100A8/A9 and S100A12 can predict response to RTX treatment in LN after 6 months.

Conclusions

Findings from this study show promise for clinical application of S100 proteins to predict active renal disease in SLE and response to treatment with RTX.
Evidence from systematic reviews of randomized trials on enteral lactoferrin supplementation in preterm neonates
Authors: Pammi Mohan , Preidis Geoffrey A. , Tarnow-Mordi William O.
Published: July 2020

In this commentary, we summarize the current evidence from randomized controlled trials on enteral lactoferrin supplementation in preterm neonates. Our recently completed systematic review includes 12 randomized controlled trials performed all over the world. Our meta-analysis suggests clinical benefit in decreasing late-onset sepsis, late-onset fungal sepsis, length of stay in the hospital and urinary tract infections. There were no adverse effects. There was no statistically significant decrease in necrotizing enterocolitis, mortality or neurodevelopmental impairment in lactoferrin supplemented preterm infants. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis between larger and smaller studies, which may reflect either small study biases, differences in the effectiveness, dose or duration of supplemental lactoferrin products, or differences in underlying population risk, or any or all of these.
A review of machine learning applications in wildfire science and management
Authors: Jain Piyush , Coogan Sean C.P. , Subramanian Sriram Ganapathi , Crowley Mark , Taylor Steve , Flannigan Mike D.
Published: July 2020

Artificial intelligence has been applied in wildfire science and management since the 1990s, with early applications including neural networks and expert systems. Since then, the field has rapidly progressed congruently with the wide adoption of machine learning (ML) methods in the environmental sciences. Here, we present a scoping review of ML applications in wildfire science and management. Our overall objective is to improve awareness of ML methods among wildfire researchers and managers, as well as illustrate the diverse and challenging range of problems in wildfire science available to ML data scientists. To that end, we first present an overview of popular ML approaches used in wildfire science to date and then review the use of ML in wildfire science as broadly categorized into six problem domains, including (i) fuels characterization, fire detection, and mapping; (ii) fire weather and climate change; (iii) fire occurrence, susceptibility, and risk; (iv) fire behavior prediction; (v) fire effects; and (vi) fire management. Furthermore, we discuss the advantages and limitations of various ML approaches relating to data size, computational requirements, generalizability, and interpretability, as well as identify opportunities for future advances in the science and management of wildfires within a data science context. In total, to the end of 2019, we identified 300 relevant publications in which the most frequently used ML methods across problem domains included random forests, MaxEnt, artificial neural networks, decision trees, support vector machines, and genetic algorithms. As such, there exists opportunities to apply more current ML methods — including deep learning and agent-based learning — in the wildfire sciences, especially in instances involving very large multivariate datasets. We must recognize, however, that despite the ability of ML models to learn on their own, expertise in wildfire science is necessary to ensure realistic modelling of fire processes across multiple scales, while the complexity of some ML methods such as deep learning requires a dedicated and sophisticated knowledge of their application. Finally, we stress that the wildfire research and management communities play an active role in providing relevant, high-quality, and freely available wildfire data for use by practitioners of ML methods.
Predictions for $$B_s \rightarrow {\bar{K}}^* \ell \,\ell $$ in non-universal $$Z'$$ models
Authors: Alok Ashutosh Kumar , Dighe Amol , Gangal Shireen , Kumar Dinesh
Published: July 2020

The lepton flavor universality violating (LFUV) measurements $$R_K$$RK and $$R_{K^*}$$RK∗ in B meson decays can be accounted for in non-universal $$Z'$$Z′ models. We constrain the couplings of these $$Z'$$Z′ models by performing a global fit to correlated $$b \rightarrow s \ell \ell $$b→sℓℓ and $$b \rightarrow d \ell \ell $$b→dℓℓ processes, and calculate their possible implications for $$B_s \rightarrow {\bar{K}}^*\ell \ell $$Bs→K¯∗ℓℓ observables. For real new physics (NP) couplings, the 1$$\sigma $$σ favored parameters allow the corresponding LFUV ratio $$R_{K^*}^{(s)}$$RK∗(s) in $$B_s \rightarrow {\bar{K}}^*\ell \ell $$Bs→K¯∗ℓℓ to range between 0.8 and 1.2 at low $$q^2$$q2. Complex NP couplings improve the best fit only marginally, however they allow a significant enhancement of the branching ratio, while increasing the range of $$R_{K^*}^{(s)}\ $$RK∗(s)at low $$q^2$$q2 to 0.8–1.8. We find that NP could cause zero-crossing in the forward–backward asymmetry $$A_{FB}$$AFB to shift towards lower $$q^2$$q2 values, and enhancement in the magnitude of integrated $$A_{FB}$$AFB. The CP asymmetry $$A_{CP}$$ACP may be suppressed and even change sign. The simultaneous measurements of integrated $$R_{K^*}^{(s)}\ $$RK∗(s)and $$A_{CP}$$ACP values to 0.1 and 1% respectively, would help in constraining the effective NP Wilson coefficient $$C_9$$C9 in $$ b \rightarrow d \mu \mu $$b→dμμ interactions.
Stability and Accuracy Analysis of Real-Time Hybrid Simulation (RTHS) with Incomplete Boundary Conditions and Actuator Delay
Authors: Tang Yu , Qin Hui
Published: July 2020

The main purpose of this paper is to examine the effects of incomplete boundary conditions and actuator delay on the dynamic responses of seismically excited civil structures. A set of constraint equations representing the reserved interface degrees-of-freedom (DOFs) and the delay are introduced to form a mechanical model of real-time hybrid simulation (RTHS) (referred to as RTHS-I&A) for a multi-degree-of-freedom (MDOF) system based on dynamic substructure method (DSM). Then, the RTHS-I&A system is modeled by a discrete closed-loop transfer function based on discrete control theory, using a selected integration algorithm, and the stability of the system is investigated by examining the poles of the function. Three typical cases with different structural properties are utilized to investigate the effects of incomplete boundary conditions and actuator delay. The results show that both incomplete boundary conditions and actuator delay greatly affect the dynamic responses of structures, and the combination of the two factors will amplify their influence especially on the nodes at the interface. The numerical model of RTHS-I&A proposed in this paper is quite useful for evaluating the responses of structures with different interface conditions and loading schemes that are preliminarily designed before a physical testing is conducted, and provides guidance for future relevant researches.
Ab-initio binding of barnase–barstar with DelPhiForce steered Molecular Dynamics (DFMD) approach
Authors: Koirala Mahesh , Alexov Emil
Published: July 2020

Receptor–ligand interactions are involved in various biological processes, therefore understanding the binding mechanism and ability to predict the binding mode are essential for many biological investigations. While many computational methods exist to predict the 3D structure of the corresponding complex provided the knowledge of the monomers, here we use the newly developed DelPhiForce steered Molecular Dynamics (DFMD) approach to model the binding of barstar to barnase to demonstrate that first-principles methods are also capable of modeling the binding. Essential component of DFMD approach is enhancing the role of long-range electrostatic interactions to provide guiding force of the monomers toward their correct binding orientation and position. Thus, it is demonstrated that the DFMD can successfully dock barstar to barnase even if the initial positions and orientations of both are completely different from the correct ones. Thus, the electrostatics provides orientational guidance along with pulling force to deliver the ligand in close proximity to the receptor.