bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of sol-immobilized bimetallic Au–Pd/TiO
2
catalysts: reduction of 4-nitrophenol to 4-aminophenol for wastewater remediation
Authors: Alshammari Khaled , Niu Yubiao , Palmer Richard E. , Dimitratos Nikolaos
Published: July 2020

A sol-immobilization method is used to synthesize a series of highly active and stable Au

x

Pd

1−
x

/TiO
2
catalysts (where
x
 = 0, 0.13, 0.25, 0.5, 0.75, 0.87 and 1) for wastewater remediation. The catalytic performance of the materials was evaluated for the catalytic reduction of 4-nitrophenol, a model wastewater contaminant, using NaBH
4
as the reducing agent under mild reaction conditions. Reaction parameters such as substrate/metal and substrate/reducing agent molar ratios, reaction temperature and stirring rate were investigated. Structure-activity correlations were studied using a number of complementary techniques including X-ray powder diffraction, X-ray photoelectron spectroscopy and transmission electron microscopy. The sol-immobilization route provides very small Au–Pd alloyed nanoparticles, with the highest catalytic performance shown by the Au
0.5
Pd
0.5
/TiO
2
catalyst.

This article is part of a discussion meeting issue ‘Science to enable the circular economy’.
Methanol photo-reforming with water on pure titania for hydrogen production
Authors: Bowker M. , Jones W.
Published: July 2020

The behaviour of titania for the photo-reforming of methanol with water at ambient temperature has been examined. It is shown that the reactivity is very poor, compared with metal-loaded catalysts at low methanol levels in solution, but the rate becomes much higher at high methanol levels, such that the difference from metal-loaded samples is much less. The optimum yield is with approximately a 1 : 1 methanol/water solution. The reaction also proceeds well in the gas phase. During all such catalysis, the titania becomes blue, due to light absorption increasing across the range 400–800 nm. However, this does not result in visible range activity for the photo-reforming and is due to the reduction of the material in the presence of light and the formation of anion vacancies and Ti
3+
centres. These anion vacancies are only very slowly re-oxidized in air on P25 titania, taking days to recover the original whiteness of the oxide. The performance of anatase, rutile and the mixed phase is compared.

This article is part of a discussion meeting issue ‘Science to enable the circular economy'.
The formation of methanol from glycerol bio-waste over doped ceria-based catalysts
Authors: Devlia Jay , Smith Louise , Douthwaite Mark , Taylor Stuart H. , Willock David J. , Hutchings Graham J. , Dummer Nicholas F.
Published: July 2020

A series of ceria-based solid solution metal oxides were prepared by co-precipitation and evaluated as catalysts for glycerol cleavage, principally to methanol. The catalyst activity and selectivity to methanol were investigated with respect to the reducibility of the catalysts. Oxides comprising Ce-Pr and Ce-Zr were prepared, calcined and compared to CeO
2
, Pr
6
O
11
and ZrO
2
. The oxygen storage capacity of the catalysts was examined with analysis of Raman spectroscopic measurements and a temperature programmed reduction, oxidation and reduction cycle. The incorporation of Pr resulted in significant defects, as evidenced by Raman spectroscopy. The materials were evaluated as catalysts for the glycerol to methanol reaction, and it was found that an increased defect density or reducibility was beneficial. The space–time yield of methanol normalized to surface area over CeO
2
was found to be 0.052 mmol
MeOH 
m
−2 
h
−1
, and over CeZrO
2
and CePrO
2
, this was to 0.029 and 0.076 mmol
MeOH 
m
−2 
h
−1
, respectively. The inclusion of Pr reduced the surface area; however, the carbon mole selectivity to methanol and ethylene glycol remained relatively high, suggesting a shift in the reaction pathway compared to that over ceria.

This article is part of a discussion meeting issue ‘Science to enable the circular economy'.
The direct synthesis of hydrogen peroxide from H
2
and O
2
using Pd–Ni/TiO
2
catalysts
Authors: Crole David A. , Underhill Ricci , Edwards Jennifer K. , Shaw Greg , Freakley Simon J. , Hutchings Graham J. , Lewis Richard J.
Published: July 2020

The direct synthesis of hydrogen peroxide (H
2
O
2
) from molecular H
2
and O
2
offers an attractive, decentralized alternative to production compared to the current means of production, the anthraquinone process. Herein we evaluate the performance of a 0.5%Pd–4.5%Ni/TiO
2
catalyst in batch and flow reactor systems using water as a solvent at ambient temperature. These reaction conditions are considered challenging for the synthesis of high H
2
O
2
concentrations, with the use of sub-ambient temperatures and alcohol co-solvents typical. Catalytic activity was observed to be stable to prolonged use in multiple batch experiments or in a flow system, with selectivities towards H
2
O
2
of 97% and 85%, respectively. This study was carried out in the absence of halide or acid additives that are typically used to inhibit sequential H
2
O
2
degradation reactions showing that this Pd–Ni catalyst has the potential to produce H
2
O
2
selectively.

This article is part of a discussion meeting issue ‘Science to enable the circular economy’.
The contribution of case mix, skill mix and care processes to the outcomes of community hospitals: a population-based observational study
Authors: Pianori Davide , Cedric Adja Kadjo Yves , Lenzi Jacopo , Pieri Giulia , Rossi Andrea , Fantini Maria Pia
Published: July 2020

Background

New organizational models to face the unmet needs of frail patients are needed. Community hospitals (CHs) could foster integration between acute and primary care. The aim of this study was to investigate which patients’ characteristics and which care processes affect clinical outcomes, in order to identify who could benefit the most from CH care.

Methods

This study included all patients aged ≥65 and discharged in 2017 from the 16 CHs of Emilia-Romagna, Italy. Data sources were the regional CH informative system and hospital discharge records. CH skill mix and processes of care were collected with a survey. The study outcome was variation of the Barthel index (BI). We performed a 2-level random-intercept logistic regression analysis, and used the variance partition coefficient (VPC) to quantify the proportion of BI improvement that lay at CH level.

Results

Of the 13 CHs, 8 had a general practitioner medical support model, and 6 had >12 nurses’ working hours/week/bed. Overall, 53% of the patients had a BI improvement ≥10. The patient case mix explained a portion of variability across CHs. Skill mix and processes of care were not associated with BI change.

Conclusions

Patients’ characteristics explained part of between-CH variation in BI improvement. Professional skill mix and processes of care, albeit fundamental to achieve appropriate care and respond to the unmet needs of the frail elderly, did not account for differences in CH-specific outcomes.
Safe contact tracing for COVID-19: A method without privacy breach using functional encryption techniques based-on spatio-temporal trajectory data
Authors: Kim Wooil , Lee Hyubjin , Chung Yon Dohn
Published: July 2020

The COVID-19 pandemic has spread all over the globe. In the absence of a vaccine, a small number of countries have managed to control the diffusion of viruses by early detection and early quarantine. South Korea, one of the countries which have kept the epidemics well-controlled, has opened the infected patients’ trajectory to the public. Such a reaction has been regarded as an effective method, however, serious privacy breach cases have been issued in South Korea. Furthermore, some suspected contacts have refused to take infection tests because they are afraid of being exposed. To solve this problem, we propose a privacy-preserving contact tracing method based on spatio-temporal trajectory which can be practically used in many quarantine systems. In addition, we develop a system to visualize the contact tracing workflow.
Quantitative assessment of motor neglect
Authors: Toba Monica N. , Pagliari Chiara , Rabuffetti Marco , Nighoghossian Norbert , Rode Gilles , Cotton François , Spinazzola Lucia , Baglio Francesca , Migliaccio Raffaella , Bartolomeo Paolo
Published: July 2020

Objectives

We used differential actigraphy as a novel, objective method to quantify motor neglect (a clinical condition whereby patients mimic hemiplegia even in the absence of sensorimotor deficits), whose diagnosis is at present highly subjective, based on the clinical observation of patients’ spontaneous motor behavior.

Methods

Patients wear wristwatch-like accelerometers, which record spontaneous motor activity of their upper limbs during 24 hours. Asymmetries of motor behavior are then automatically computed offline. On the basis of normal participants’ performance, we calculated cut-off scores of left/right motor asymmetry.

Results

Differential actigraphy showed contralesional motor neglect in nine of 35 patients with unilateral strokes, consistent with clinical assessment. An additional patient with clinical signs of motor neglect obtained a borderline asymmetry score. Lesion location in a subgroup of 25 patients was highly variable, suggesting that motor neglect is a heterogenous condition.

Conclusions

Differential actigraphy provides an ecological measure of spontaneous motor behavior, and can assess upper limb motricity in an objective and quantitative manner. It thus offers a convenient, cost-effective, and relatively automatized procedure for following-up motor behavior in neurological patients, and to assess the effects of rehabilitation.
Interaction of Heavy Drinking Patterns and Depression Severity predicts Efficacy of Quetiapine Fumarate XR in lowering Alcohol Intake in Alcohol Use Disorder Patients
Authors: Vatsalya Vatsalya , Kong Maiying , Marsano Luis M. , Kurlawala Zimple , Chandras Kan V. , Schwandt Melanie L. , Ramchandani Vijay A. , McClain Craig J.
Published: July 2020

Background

Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression.

We investigated the role of depression ratings and patterns of heavy drinking on the treatment efficacy of Quetiapine fumarate XR in lowering alcohol intake in alcohol use disorder (AUD) patients.

Methods

One hundred and eight male and female heavy drinking AUD patients in the age range of 18–64 yrs. received 12 weeks of active treatment. Participants were grouped by the severity grading of depression using Montgomery-Asberg Depression Rating Scale (MADRS) (clinically relevant≥8 [CR], clinically non-relevant≤7 [CNR]) at baseline. Drinking history and depression ratings were assessed at the patients visits.

Results

Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD and AvgD) and MADRS scores by the end of the treatment course.

Conclusions

Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR.

ClinicalTrials.gov

NCT#0049862 (https://clinicaltrials.gov/ct2/show/NCT00498628?term=litten&draw=2&rank=3)
Genetic risk factors for death with SARS-CoV-2 from the UK Biobank
Authors: Lu Chang , Gam Rihab , Pandurangan Arun Prasad , Gough Julian
Published: July 2020

We present here genetic risk factors for survivability from infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for coronavirus disease 19 (COVID-19). At the time of writing it is too early to determine comprehensively and without doubt all risk factors, but there is an urgency due to the global pandemic crisis that merits this early analysis. We have nonetheless discovered 5 novel risk variants in 4 genes, discovered by examining 193 deaths from 1,412 confirmed infections in a group of 5,871 UK Biobank participants tested for the virus. We also examine the distribution of these genetic variants across broad ethnic groups and compare it to data from the UK Office of National Statistics for increased risk of death from SARS-CoV-2. We confidently identify the gene ERAP2 with a high-risk variant, as well as three other genes of potential interest. Although mostly rare, a common theme of genetic risk factors affecting survival might be the inability to launch or modulate an effective immune and stress response to infection from the SARS-CoV-2 virus.
Connectivity patterns of task-specific brain networks allow individual prediction of cognitive symptom dimension of schizophrenia and link to molecular architecture
Authors: Chen Ji , Müller Veronika I. , Dukart Juergen , Hoffstaedter Felix , Baker Justin T. , Holmes Avram J. , Vatansever Deniz , Nickl-Jockschat Thomas , Liu Xiaojin , Derntl Birgit , Kogler Lydia , Jardri Renaud , Gruber Oliver , Aleman André , Sommer Iris E. , Eickhoff Simon B. , Patil Kaustubh R.
Published: July 2020

Background

Despite the marked inter-individual variability in the clinical presentation of schizophrenia, it remains unclear the extent to which individual dimensions of psychopathology may be reflected in variability across the collective set of functional brain connections. Here, we address this question using network-based predictive modeling of individual psychopathology along four data-driven symptom dimensions. Follow-up analyses assess the molecular underpinnings of predictive networks by relating them to neurotransmitter-receptor distribution patterns.

Methods

We investigated resting-state fMRI data from 147 schizophrenia patients recruited at seven sites. Individual expression along negative, positive, affective, and cognitive symptom dimensions was predicted using relevance vector machine based on functional connectivity within 17 meta-analytic task-networks following a repeated 10-fold cross-validation and leave-one-site-out analyses. Results were validated in an independent sample. Networks robustly predicting individual symptom dimensions were spatially correlated with density maps of nine receptors/transporters from prior molecular imaging in healthy populations.

Results

Ten-fold and leave-one-site-out analyses revealed five predictive network-symptom associations. Connectivity within theory-of-mind, cognitive reappraisal, and mirror neuron networks predicted negative, positive, and affective symptom dimensions, respectively. Cognitive dimension was predicted by theory-of-mind and socio-affective-default networks. Importantly, these predictions generalized to the independent sample. Intriguingly, these two networks were positively associated with D1dopamine receptor and serotonin reuptake transporter densities as well as dopamine-synthesis-capacity.

Conclusions

We revealed a robust association between intrinsic functional connectivity within networks for socio-affective processes and the cognitive dimension of psychopathology. By investigating the molecular architecture, the present work links dopaminergic and serotonergic systems with the functional topography of brain networks underlying cognitive symptoms in schizophrenia.
An Automatic Computer-Based Method for Fast and Accurate Covid-19 Diagnosis
Authors: Jaid Jim Abdullah Al , Rafi Ibrahim , Chowdhury Md. Sanaullah , Sikder Niloy , Mahmud M. A. Parvez , Rubaiee Saeed , Masud Mehedi , Bairagi Anupam Kumar , Bhakta Kangkan , Nahid Abdullah-Al
Published: July 2020

At present, the whole world is witnessing a horrifying outbreak caused by the Coronavirus Disease 2019 (COVID-19). The virus responsible for this disease is called SARS-CoV-2. It affects its victims’ respiratory system and causes severe lung inflammation, making it harder for them to breathe. The virus is airborne, and so has a high infection rate. Originated in China last December, the virus has spread across seven continents, affecting the population of over 210 countries, making it one of the fiercest pandemics ever recorded. Despite multiple independent and collaborative attempts to develop a vaccine or a cure, an effective solution is yet to come out. While the disease has put the world in a standstill, detecting the positive subjects and isolating them from the others as soon as possible is the only way to minimize its spread. However, many countries are currently experiencing a massive shortage of diagnostic equipment and medical personals. This insufficiency inspired us to work on a computer-based automatic method for the diagnosis of COVID-19. In this paper, we proposed a sequential Convolutional Neural Network (CNN)-based model to detect COVID-19 through analyzing Computed Tomography (CT) scan images. The model is capable of identifying the disease with almost 92.5% accuracy. We believe the implementation of this model will help the physicians and pathologists all over the world to single out the victims quickly and thus reduce the prevalence of COVID-19.
Is nasopharyngeal swab comparable with nasopharyngeal aspirate to detect SARS-CoV-2 in children?
Authors: Capecchi Ester , Di Pietro Giada Maria , Luconi Ester
Published: July 2020

The tests currently used for the direct identification of SARS-CoV-2 include specimens taken from the upper and the lower respiratory tract.

In our paediatric department all children undergo both nasopharyngeal swab and nasopharyngeal aspirate, performed from both nostrils, on admission and after 24 hours.

We decided to compare these two methods of detection of SARS-CoV-2. Considering nasopharyngeal aspirate as the gold standard, we calculated sensitivities and specificities of nasopharyngeal swab.

Based on our results, we suggest to prefer the collection of aspirates whenever possible.
Characterization of Microbial Co-infections in the Respiratory Tract of hospitalized COVID-19 patients
Authors: Zhong Huanzi , Wang Yanqun , Shi Zhun , Zhang Lu , Ren Huahui , He Weiqun , Zhang Zhaoyong , Zhu Airu , Zhao Jingxian , Xiao Fei , Yang Fangming , Liang Tianzhu , Ye Feng , Zhong Bei , Ruan Shicong , Gan Mian , Zhu Jiahui , Li Fang , Li Fuqiang , Wang Daxi , Li Jiandong , Ren Peidi , Zhu Shida , Yang Huanming , Wang Jian , Kristiansen Karsten , Tun Hein Min , Chen Weijun , Zhong Nanshan , Xu Xun , Li Yi-min , Li Junhua , Zhao Jincun
Published: July 2020

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of Coronavirus disease 2019 (COVID-19). However, microbial composition of the respiratory tract and other infected tissues, as well as their possible pathogenic contributions to varying degrees of disease severity in COVID-19 patients remain unclear.

Method

Between January 27 and February 26, 2020, serial clinical specimens (sputum, nasal and throat swab, anal swab and feces) were collected from a cohort of hospitalized COVID-19 patients, including 8 mildly and 15 severely ill patients (requiring ICU admission and mechanical ventilation), in the Guangdong province, China. Total RNA was extracted and ultra-deep metatranscriptomic sequencing was performed in combination with laboratory diagnostic assays. Co-infection rates, the prevalence and abundance of microbial communities in these COVID-19 patients were determined.

Findings

Notably, respiratory microbial co-infections were exclusively found in 84.6% of severely ill patients (11/13), among which viral and bacterial co-infections were detected by sequencing in 30.8% (4/13) and 69.2% (9/13) of the patients, respectively. In addition, for 23.1% (3/13) of the patients, bacterial co-infections with Burkholderia cepacia complex (BCC) and Staphylococcus epidermidis were also confirmed by bacterial culture. Further, a time-dependent, secondary infection of B. cenocepacia with expressions of multiple virulence genes in one severely ill patient was demonstrated, which might be the primary cause of his disease deterioration and death one month after ICU admission.

Interpretation

Our findings identified distinct patterns of co-infections with SARS-CoV-2 and various respiratory pathogenic microbes in hospitalized COVID-19 patients in relation to disease severity. Detection and tracking of BCC-associated nosocomial infections are recommended to improve the pre-emptive treatment regimen and reduce fatal outcomes of hospitalized patients infected with SARS-CoV-2.

Funding

National Science and Technology Major Project of China, National Major Project for Control and Prevention of Infectious Disease in China, the emergency grants for prevention and control of SARS-CoV-2 of Ministry of Science and Technology and Guangdong province, Guangdong Provincial Key Laboratory of Genome Read and Write, Guangdong Provincial Academician Workstation of BGI Synthetic Genomics, and Shenzhen Engineering Laboratory for Innovative Molecular Diagnostics.
Covid-19 Risk Among Airline Passengers: Should the Middle Seat Stay Empty?
Authors: Barnett Arnold
Published: July 2020

We use recent data and research results to approximate the probability that an air traveler in coach will contract Covid-19 on a US domestic flight two hours long, both when all coach seats are full and when all but middle seats are full. The point estimates we reach based on data from late June 2020 are 1 in 4,300 for full flights and 1 in 7,700 when middle seats are kept empty. These estimates are subject to both quantifiable and nonquantifiable sources of uncertainty, and sustain known margins of error of a factor about 2.5. However, because uncertainties in key parameters affect both risk estimates the same way, they leave the relative risk ratio for “fill all seats” compared to “middle seat open” close to 1.8 (i.e., close to 1/4,300)/(1/7,700). We estimate the mortality risks caused by Covid-19 infections contracted on airplanes, taking into account that infected passengers can in turn infect others. The point estimates—which use 2019 data about the percentage of seats actually occupied on US flights--range from one death per 400,000 passengers to one death per 600,000. These death-risk levels are considerably higher than those associated with plane crashes but comparable to those arising from two hours of everyday activities during the pandemic.
Convolutional neural networks on eye tracking trajectories classify patients with spatial neglect
Authors: Franceschiello Benedetta , Noto Tommaso Di , Bourgeois Alexia , Murray Micah M. , Minier Astrid , Pouget Pierre , Richiardi Jonas , Bartolomeo Paolo , Anselmi Fabio
Published: July 2020

Background and Objective

Eye-movement trajectories are rich behavioral data, providing a window on how the brain processes information. We address the challenge of characterizing signs of visuo-spatial neglect from saccadic eye trajectories recorded in brain-damaged patients with spatial neglect as well as in healthy controls during a visual search task.

Methods

We establish a standardized preprocessing pipeline adaptable to other task-based eye-tracker measurements. We use a deep convolutional network, a very successful type of neural network architecture in many computer vision applications, including medical diagnosis systems, to automatically analyze eye trajectories.

Results

Our algorithm can classify brain-damaged patients vs. healthy individuals with an accuracy of 86±5%. Moreover, the algorithm scores correlate with the degree of severity of neglect signs estimated with standardized paper-and-pencil test and with white matter tracts impairment via Diffusion Tensor Imaging (DTI). Interestingly, the latter showed a clear correlation with the third branch of the superior longitudinal fasciculus (SLF), especially damaged in neglect.

Conclusions

The study introduces a new classification method to analyze eyes trajectories in patients with neglect syndrome. The method can likely be applied to other types of neurological diseases opening to the possibility of new computer-aided, precise, sensitive and non-invasive diagnosing tools.

Highlights

We identify signs of visuo-spatial neglect through an automated analysis of saccadic eye trajectories using deep convolutional neural networks (CNNs).

We provide a standardized pre-processing pipeline adaptable to other task-based eye-tracker measurements.

Patient-wise, we benchmark the algorithm prediction with standardized paper-and-pencil test results.

We evaluate white matter tracts by using Diffusion Tensor Imaging (DTI) and find a clear correlation with the microstructure of the third branch of the superior longitudinal fasciculus.

Deep CNNs can efficiently and non-invasively characterize left spatial neglect.
Revealing antibiotic cross-resistance patterns in hospitalized patients through Bayesian network modelling
Authors: Cherny Stacey S , Nevo Daniel , Baraz Avi , Baruch Shoham , Lewin-Epstein Ohad , Stein Gideon Y , Obolski Uri
Published: July 2020

Objectives

Microbial resistance exhibits dependency patterns between different antibiotics, termed cross-resistance and collateral sensitivity. These patterns differ between experimental and clinical settings. It is unclear whether the differences result from biological reasons or from confounding, biasing results found in clinical settings. We set out to elucidate the underlying dependency patterns between resistance to different antibiotics from clinical data, while accounting for patient characteristics and previous antibiotic usage.

Methods

Additive Bayesian network modelling was employed to simultaneously estimate relationships between variables in a dataset of bacterial cultures derived from hospitalized patients and tested for resistance to multiple antibiotics. Data contained resistance results, patient demographics, and previous antibiotic usage, for five bacterial species:E. coli(n=1054),K. pneumoniae(n=664),P. aeruginosa(n=571), CoNS (n=495), andP. mirabilis(n=415).

Results

All links between resistance to the various antibiotics were positive. Multiple direct links between resistance of antibiotics from different classes were observed across bacterial species. For example, resistance to gentamicin inE.coliwas directly linked with resistance to ciprofloxacin (OR = 8.39, 95%CI[5.58, 13.30]) and sulfamethoxazole-trimethoprim (OR = 2.95, 95%CI[1,97, 4.51]). In addition, resistance to various antibiotics was directly linked with previous antibiotic usage.

Conclusions

Robust relationships among resistance to antibiotics belonging to different classes, as well as resistance being linked to having taken antibiotics of a different class, exist even when taking into account multiple covariate dependencies. These relationships could help inform choices of antibiotic treatment in clinical settings.
Manual ability in hand surgery patients: validation of the ABILHAND scale in four diagnostic groups
Authors: Khoury Ghady El , Barbier Olivier , Libouton Xavier , Thonnard Jean-Louis , Lefevre Philippe , Penta Massimo
Published: July 2020

Background

Patients treated in hand surgery (HS) belong to different demographic groups and have varying impairments related to different pathologies. HS outcomes are measured to assess treatment results, complication risks and intervention reliability. Quantitative analysis of functional recovery requires a unidimensional, linear scale.

Objective

To adapt the ABILHAND questionnaire through Rasch analysis for specific use in HS patients and to examine its validity.

Methods

A preliminary 90-item questionnaire was presented to 216 patients representing the diagnoses most frequently encountered in HS, including distal radius fracture (n=74), basal thumb arthritis (n=66), carpal tunnel syndrome (n=53), and heavy wrist surgery (n=23). Patients were assessed during the early recovery and in the late follow-up period (0-3 months, 3–6 months and >6 months), leading to a total of 305 assessments. They rated their perceived difficulty with queried activities as impossible, difficult, or easy. Responses were analyzed using the RUMM2030 software. Items were refined based on item-patient targeting, fit statistics, differential item functioning, local independence and item redundancy. Patients also completed the QuickDASH, 12-item Short Form Survey (SF-12) and a numerical pain scale.

Results

The rating scale Rasch model was used to select 23 mostly bimanual items on a 3-level scale, which constitute a unidimensional, linear measure of manual ability with good reliability across all included diagnostic groups (Person-Separation Index = 0.90). The resulting scale was found to be invariant across demographic and clinical subgroups and over time. ABILHAND-HS patient measures correlated significantly (p<0.001) with the QuickDASH (r=-0.77), SF-12 Physical Component Summary (r=0.56), SF-12 Mental Component Summary (r=0.31), and pain scale (r=-0.49).

Conclusion

ABILHAND-HS is a robust person-centered measure of manual ability in HS patients.
Transfer RNA fragments replace microRNA regulators of the cholinergic post-stroke immune blockade
Authors: Winek Katarzyna , Lobentanzer Sebastian , Nadorp Bettina , Dubnov Serafima , Dames Claudia , Moshitzky Gilli , Hotter Benjamin , Meisel Christian , Greenberg David S , Shifman Sagiv , Klein Jochen , Shenhar-Tsarfaty Shani , Meisel Andreas , Soreq Hermona
Published: July 2020

Stroke is a leading cause of death and disability. Recovery depends on balance between inflammatory response and immune suppression, which can be CNS-protective but may worsen prognosis by increasing patients’ susceptibility to infections. Peripheral cholinergic blockade of immune reactions fine-tunes this immune response, but its molecular regulators are unknown. Therefore, we sought small RNA balancers of the cholinergic anti-inflammatory pathway in peripheral blood from ischemic stroke patients. Using RNA-sequencing and RT-qPCR, we discovered in patients’ blood on day 2 after stroke a “change of guards” reflected in massive decreases in microRNAs (miRs) and increases in transfer RNA fragments (tRFs) targeting cholinergic transcripts. Electrophoresis-based size-selection followed by RT-qPCR validated the top 6 upregulated tRFs in a separate cohort of stroke patients, and independent small RNA-sequencing datasets presented post-stroke enriched tRFs as originating from lymphocytes and monocytes. In these immune compartments, we found CD14+ monocytes to express the highest amounts of cholinergic transcripts. In-depth analysis of CD14+ regulatory circuits revealed minimally overlapping subsets of transcription factors carrying complementary motifs to miRs or tRFs, indicating different roles for the stroke-perturbed members of these small RNA species. Furthermore, LPS-stimulated murine RAW264.7 cells presented dexamethasone-suppressible upregulation of the top 6 tRFs identified in human patients, indicating an evolutionarily conserved and pharmaceutically treatable tRF response to inflammatory cues. Our findings identify tRF/miR subgroups which may co-modulate the homeostatic response to stroke in patients’ blood and open novel venues for establishing RNA-targeted concepts for post-stroke diagnosis and therapeutics.
Metabolic indicators associated with non-communicable diseases deteriorated in COVID-19 outbreak: evidence from a two-center, retrospective study
Authors: Xue Ting , Xu Lizhen , Mao Yaqian , Lin Wei , Liang Jixing , Huang Huibin , Li Liantao , Wen Junping , Chen Gang
Published: July 2020

Objective

Our study aimed to investigate whether the metabolic indicators associated with non-communicable diseases (NCDs) in the general population have changed during the COVID-19 outbreak.

METHODS

This retrospective self-controlled study enrolled adult participants with metabolic indicators relate to NCDs followed at Fujian Provincial Hospital and Fujian Provincial Hospital South Branch. The metabolic indicators followed during January 1, 2020 and April 30, 2020, the peak period of the COVID-19 epidemic in China, were compared with the baseline value in the same period last year. Pared-samples T-test and Wilcoxon signed-rank test were performed to analyze the differences between paired data.

Results

The follow-up total cholesterol was significantly increased than that of the baseline (4.73 (4.05, 5.46) mmol/L vs 4.71 (4.05, 5.43) mmol/L, p=0.019; n=3379). Similar results were observed in triglyceride (1.29 (0.91, 1.88) vs 1.25 (0.87, 1.81) mmol/L, p<0.001; n=3381), uric acid (330.0 (272.0, 397.0) vs 327.0 (271.0, 389.0) umol/L, p<0.001; n=3364), and glycosylated hemoglobin (6.50 (6.10, 7.30) vs 6.50 (6.10, 7.20) %, p=0.013; n=532). No significant difference was observed in low density lipoprotein, body mass index and blood pressure.

Conclusions

Metabolic indicators associated with NCDs deteriorated in the COVID-19 outbreak. We should take action to prevent and control NCDs without delay.
Highly predictive regression model of active cases of COVID-19 in a population by screening wastewater viral load
Authors: Vallejo Juan A. , Rumbo-Feal Soraya , Conde-Pérez Kelly , López-Oriona Ángel , Tarrío Javier , Reif Rubén , Ladra Susana , Rodiño-Janeiro Bruno K. , Nasser Mohammed , Cid Ángeles , Veiga María C , Acevedo Antón , Lamora Carlos , Bou Germán , Cao Ricardo , Poza Margarita
Published: July 2020

The quantification of the SARS-CoV-2 load in wastewater has emerged as a useful method to monitor COVID-19 outbreaks in the community. This approach was implemented in the metropolitan area of A Coruña (NW Spain), where wastewater from the treatment plant of Bens was analyzed to track the epidemic’s dynamic in a population of 369,098 inhabitants. We developed statistical regression models that allowed us to estimate the number of infected people from the viral load detected in the wastewater with a reliability close to 90%. This is the first wastewater-based epidemiological model that could potentially be adapted to track the evolution of the COVID-19 epidemic anywhere in the world, monitoring both symptomatic and asymptomatic individuals. It can help to understand with a high degree of reliability the true magnitude of the epidemic in a place at any given time and can be used as an effective early warning tool for predicting outbreaks.
Antibiotics resistance and mitigation strategies in healthcare settings: A scoping review
Authors: Okeah O.O. , Morrison V. , Huws J.
Published: July 2020

Background

According to the European Center for Disease Prevention and Control (ECDC), the EU records an estimated 3.2 million healthcare associated infections (HAIs) and an associated 37,000 deaths annually. A significant proportion of the HAIs burden is attributable to multi-drug resistant organisms (MDROs). Infectious diseases remain top on the list of the leading causes of death globally with MDROs playing a significant role. Key amongst these organisms isClostridium difficileandKlebsiella pneumoniaewhich belong to the broader group of ESKAPE pathogens.

Aims

This review aimed at identifying literature on interventions targetingClostridium difficileandKlebsiella pneumoniae, their key outcomes, and the extent to which behavioural theory has been applied in such interventions.

Methods

This scoping review was undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. The specific databases searched included MEDLINE, PubMed, Web of Science Core Collection, and CINAHL. The process for screening articles and data extraction was undertaken in duplicate by two reviewers. A narrative synthesis of the results is provided.

Results

The review included 34 studies (16 studies onClostridium difficileand 18 articles focussed onKlebsiella pneumoniae). The specific antimicrobial stewardship interventions identified includeEducation,Surveillance andScreening,Consultations,Audits,Policies andProtocols,Environmental measures,Bundles of care,Isolation precautions, as well asNotifications and alerts systems (ESCAPE-BIN). The identified outcomes include antimicrobial use, resistance rates, risk reduction, adherence to contact precautions, hospital stay, and time savings. Only one study incorporated Kotter’s stages of behaviour change and recorded the second largest (75%) sustained reduction in antimicrobials use whereas the remainder of the studies were devoid of behavioural approaches. The highest improvement (95%) in adherence isolation precautions was reported by an intervention involving the use of an IPC bundle and an environmental cleaning protocol.

Conclusion

This scoping review identified the available evidence on antimicrobial the mitigation strategies forClostridium difficileandKlebsiella pneumoniaein healthcare settings as well as the key outcomes. There is need for further investigations on the feasibility of behaviour-based approaches in improving adherence of health workers to interventions targetingClostridium difficileandKlebsiella pneumoniae.
Determinants of Choice of Abortion Methods among Women in Ghana; Does Knowledge on legality of Abortion Matter?
Authors: Klu Desmond , Atiglo Donatus Yaw , Manyeh Alfred Kwesi , Immurana Mustapha , Dalaba Maxwell
Published: July 2020

Abstract
Objective This study therefore examines the role knowledge on legal abortion and other factors play in the choice of abortion methods among women within a ten-year period.
Design The study use data from the 2007 and 2017 Ghana Maternal Health Surveys. A total sample of 2,432 women aged 15-49 whose activities related to their most recent induced abortion were selected. This study, however, limits the analysis to a subpopulation of women who have terminated a pregnancy between 2002 to 2007 and 2012 to 2017. The made use of binary logistic regression analysis to show the relationship between choice of abortion methods and knowledge of legality of abortion.
Setting Ghana
Participants Women who had practice induce abortion
Main outcome measure Choice of Abortion methods
Results Likelihood of unsafe abortion practices was high among women who had knowledge on legality of abortion, women with no formal education, single women, rural women and women whose partners did not know about the pregnancy.
Conclusion Increasing knowledge of legal status on abortion among women corresponded with an increased in the use of unsafe abortion methods over the decade has implication for poor reproductive health outcome and increased maternal mortality among women in Ghana.
Increasing Virus Test Capacity via Recursive Pool Testing with an Application to SARS-CoV-2 Testing
Authors: Mutzel Petra , Bertram Alexander , Jünger Paul , Jünger Pauline , Krieger Horst , Schmitz Stephan , Jünger Michael
Published: July 2020

In the context of adequate reactions to the current Covid-19 pandemic, Seifried, Ciesek et al. [6, 5] have proposed the application of SARS-CoV-2 pool testing in the pursuit of increasing testing capacity. We show how this method can be substantially improved in realistic scenarios, and we point out a possible impact on the ongoing discussion concerning the need of increased testing as a complementary measure to relaxed restrictions.
A systematic review of the smartphone applications available for corona virus disease 2019 (COVID19) and their assessment using the mobile app rating scale (MARS)
Authors: Davalbhakta Samira , Advani Shailesh , Kumar Shobhit , Agarwal Vishwesh , Bhoyar Samruddhi , Fedirko Elizabeth , Misra Durga Prasanna , Goel Ashish , Gupta Latika , Agarwal Vikas
Published: July 2020

The global impact of COVID-19 pandemic has increased the need to rapidly develop and improve utilization of mobile applications across the healthcare continuum to address rising barriers of access to care due to social distancing challenges and allow continuity in sharing of health information, assist with COVID-19 activities including contact tracing, and providing useful information as needed. Here we provide an overview of mobile applications being currently utilized for COVID-19 related activities. We performed a systematic review of the literature and mobile platforms to assess mobile applications been currently utilized for COVID-19, and quality assessment of these applications using the Mobile Application Rating Scale (MARS) for overall quality, Engagement, Functionality, Aesthetics, and Information. Finally, we provide an overview of the key salient features that should be included in mobile applications being developed for future use. Our search identified 63 apps that are currently being used for COVID-19. Of these, 25 were selected from the Google play store and Apple App store in India, and 19 each from the UK and US. 18 apps were developed for sharing up to date information on COVID-19, and 8 were used for contact tracing while 9 apps showed features of both. On MARS Scale, overall scores ranged from 2.4 to 4.8 with apps scoring high in areas of functionality and lower in Engagement. Future steps should involve developing and testing of mobile applications using assessment tools like the MARS scale and the study of their impact on health behaviors and outcomes.
Tissue-specific tolerance in fatal Covid-19
Authors: Dorward David A , Russell Clark D , Um In Hwa , Elshani Mustafa , Armstrong Stuart D , Penrice-Randal Rebekah , Millar Tracey , Lerpiniere Chris EB , Tagliavini Giulia , Hartley Catherine S , Randle Nadine P , Gachanja Naomi N , Potey Philippe MD , Anderson Alison M , Campbell Victoria L , Duguid Alasdair J , Qsous Wael Al , BouHaidar Ralph , Baillie J Kenneth , Dhaliwal Kevin , Wallace William A , Bellamy Christopher OC , Prost Sandrine , Smith Colin , Hiscox Julian A , Harrison David J , Lucas Christopher D
Published: July 2020

Background

Tissue inflammation is associated with organ dysfunction and death in Covid-19. The efficacy of dexamethasone in preventing mortality in critical Covid-19 suggests that inflammation has a causal role in death. Whether this deleterious inflammation is a direct response to the presence of SARS-CoV-2, or an independent immuno-pathologic process, is unknown.

Methods

Tissue was acquired from detailed post-mortem examinations conducted on 11 well characterised hospitalised patients with fatal Covid-19. SARS-CoV-2 organotropism was mapped at an organ level by multiplex PCR and sequencing, with cellular resolution achieved by in situ viral spike (S) protein detection. Histological evidence of inflammation and organ injury was systematically examined, and the pulmonary immune response characterized with multiplex immunofluorescence.

Findings

SARS-CoV-2 was detected across a wide variety of organs, most frequently in the respiratory tract but also in numerous extra-pulmonary sites. Minimal histological evidence of inflammation was identified in non-pulmonary organs despite frequent detection of viral RNA and protein. At a cellular level, viral protein was identified without adjacent inflammation in the intestine, liver and kidney. Severe inflammatory change was restricted to the lung and reticulo-endothelial system. Diffuse alveolar damage, pulmonary thrombi and a monocyte/myeloid-predominant vasculitis were the predominant pulmonary findings, though there was not a consistent association between viral presence and either the presence or nature of the inflammatory response within the lung. Immunophenotyping revealed an influx of macrophages, monocytes and T cells into pulmonary parenchyma. Bone marrow examination revealed plasmacytosis, erythroid dysplasia and iron-laden macrophages. Plasma cell excess was also present in lymph node, spleen and lung. These stereotyped reticulo-endothelial responses occurred largely independently of the presence of virus in lymphoid tissues.

Conclusions

Tissue inflammation and organ dysfunction in fatal Covid-19 do not map to the tissue and cellular distribution of SARS-CoV-2, demonstrating tissue-specific tolerance. We conclude that death in Covid-19 is primarily a consequence of immune-mediated, rather than pathogen-mediated, organ inflammation and injury.

Funding

The Chief Scientist Office, LifeArc, Medical Research Scotland, UKRI (MRC).
Association of chronic heart failure and its comorbidities with loss of actuarially predicted life expectancy: a prospective cohort study
Authors: Drozd Michael , Relton Samuel D , Walker Andrew MN , Slater Thomas , Gierula John , Paton Maria F , Lowry Judith , Straw Sam , Koshy Aaron , McGinlay Melanie , Simms Alexander D , Gatenby V Kate , Sapsford Robert J , Witte Klaus K , Kearney Mark T , Cubbon Richard M
Published: July 2020

Background

Estimating survival can aid care planning, but the use of absolute survival projections can be challenging for patients and clinicians to contextualize. We aimed to define how heart failure and its major comorbidities contribute to loss of actuarially predicted life expectancy.

Methods

We conducted an observational cohort study of 1794 adults with stable chronic heart failure and reduced left ventricular ejection fraction, recruited from cardiology outpatient departments of 4 United Kingdom (UK) hospitals. Data from an 11-year maximum (5-year median) follow-up period (999 deaths) was used to define how heart failure and its major comorbidities impact upon survival, relative to an age-sex matched control UK population, using a relative survival framework.

Results

After 10 years, mortality in the reference control population was 29%. In people with heart failure, this increased by an additional 37% (95% confidence interval 34-40%), equating to an additional 2.2-years of lost life, or a 2.4-fold (2.2-2.5) excess loss of life. This excess was greater in men than women (2.4 years [2.2-2.7] versus 1.6 years [1.2-2.0]; p<0.001). In patients without major comorbidity, men still experienced excess loss of life, whilst women experienced less and were non-significantly different from the reference population (1 year [0.6-1.5] versus 0.4 years [-0.3-1]; p<0.001). Accrual of comorbidity was associated with substantial increases in excess loss of life, particularly for chronic kidney and lung disease.

Conclusions

Comorbidity accounts for the majority of lost life expectancy in people with heart failure. Women, but not men, without comorbidity experience survival close to reference controls.