bluuebunny/crossref_metadata_2025 huggingface dataset:
Pervasive Effects ofWolbachiaon Host Temperature Preference
Authors: Hague Michael T. J. , Caldwell Chelsey N. , Cooper Brandon S.
Published: October 2020

Microbes infect a diversity of species, influencing the performance and fitness of their hosts. Maternally transmittedWolbachiabacteria infect most insects and other arthropods, making these bacteria some of the most common endosymbionts in nature. Despite their global prevalence, it remains mostly unknown howWolbachiainfluence host physiology and behavior to proliferate. We demonstrate pervasive effects ofWolbachiaonDrosophilatemperature preference. Most hosts infected with A-groupWolbachiaprefer cooler temperatures, whereas the one host species infected with divergent B-groupWolbachiaprefers warmer temperatures, relative to uninfected genotypes. Changes to host temperature preference generally do not alterWolbachiaabundance in host tissues, but for some A-group strains, adult males have increasedWolbachiatiter when shifted to a cooler temperature. This suggests thatWolbachia-induced changes to host behavior may promote bacterial replication. Our results help elucidate the impact of endosymbionts on their hosts amid the globalWolbachiapandemic.
Detrital zircon provenance of the Indus Group, Ladakh, NW India: Implications for the timing of the India-Asia collision and other syn-orogenic processes
Authors: Bhattacharya Gourab , Robinson Delores M. , Wielicki Matthew M.
Published: October 2020

The timing of the India-Asia collision is greatly debated and is critical for elucidating early orogenic processes. This study documents, for the first time, evidence of India-Asia detrital mixing in the continental sedimentary rocks of the India-Asia collision zone of NW India at ca. 50 Ma and presents the largest detrital zircon (DZ) U-Pb age data set (n = 1225) from the region. Our DZ U-Pb age spectra from the early Eocene–late Oligocene continental Indus Group reveal a hybrid India-Asia provenance. The dominant Mesozoic–Cenozoic DZ peaks are ca. 107 Ma, 100–80 Ma, 60–50 Ma, 40 Ma, and 26 Ma, and they are mostly derived from Asia. The primary Precambrian DZ peaks are ca. 2.5 Ga, 1.2–0.95 Ga, 0.78–0.63 Ga, and 0.55 Ga and are representative of Tethyan Himalayan rocks on Greater India. Maximum depositional ages (MDAs) for four key Indus Group units, the Nurla, Hemis, Basgo, and Temesgam Formations, support syn-orogenic deposition in the Indus Basin from early Eocene to at least late Oligocene time. The Nurla Formation, with an MDA of ca. 50 Ma, records the first arrival of Greater Indian zircons on the Asian plate, thereby indicating uplift and erosion along the subducting Indian plate and collision of India with Asia by ca. 50 Ma. The ca. 27–26 Ma zircons in the younger late Oligocene Basgo and Temesgam Formations were contributed by the Lhasa terrane in south Tibet, which implies that the Indus River flowed from east to west across NW India at least by ca. 27 Ma.
Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane
Authors: Akino Kunihiko , Nagai Norihiro , Watanabe Kazuhiro , Ban Norimitsu , Kurihara Toshihide , Uchida Atsuro , Shinoda Hajime , Tsubota Kazuo , Ozawa Yoko
Published: October 2020

Background/Aims

Pars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.

Methods

Data of 30 eyes (30 patients; mean age, 66.1 years; 15 men) who underwent PPV for iERM during February 2016–June 2019 and had preoperative and postoperative visual field measurements using standard automated perimetry (Humphrey visual field analyser 30-2 program) were retrospectively analysed. Eyes with diseases other than iERM, including moderate-to-severe cataract or preoperative VFDs were excluded.

Results

VFD, defined by the Anderson and Patella’s criteria, was found in 73.3% of the eyes 1 month after PPV. After age adjustment, internal limiting membrane (ILM) peeling was identified as a risk factor for postoperative VFD (p=0.035; 95% CI 1.173 to 92.8). Postoperative VFD was frequently observed nasally (86.4%, p=0.002), and on optical coherence tomography measurements, ganglion cell layer (GCL) thinning was found temporal to the fovea (p=0.008). Thinning of the superior and inferior retinal nerve fibre layers and of the GCL temporal to the fovea were significant in eyes after ILM peeling (all p<0.05).

Conclusion

ILM peeling may cause inner retinal degeneration and lead to the development of VFDs after PPV, which should be further examined.
Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes
Authors: Nabhan Dustin , Lewis Melie , Taylor David , Bahr Roald
Published: October 2020

Aim

To assess the value of including validated screening tools for allergies, anxiety, depression, sleep apnoea and sleep quality into an electronic patient health history questionnaire.

Methods

In this descriptive study, we reviewed electronic medical records of Olympic and Paralympic athletes who completed health screenings, which included validated screens for allergies (Allergy Questionnaire for Athletes), anxiety (General Anxiety Disorder-2), depression (Patient Health Questionaire-2), sleep apnoea (Berlin Questionnaire) and sleep quality (Pittsburgh Sleep Quality Index), using established criteria for a positive screen. We report the prevalence of positive tests and the associations between positive screening tools.

Results

A total of 683 Olympic and 257 Paralympic athletes (462 male, 478 female) completed the health history between May and September of 2019. At least one positive screen was reported by 37% of athletes training for the Olympics and 48% of athletes training for the Paralympics. More than 20% of all athletes screened positive for allergies and poor sleep quality. Athletes training for the Paralympics had a significantly higher percentage of positive screens for anxiety, depression, poor sleep quality and sleep apnoea risk. Females had significantly more positive screens for allergy and poor sleep quality.

Conclusions

The addition of standardised screening tools to an electronic health history resulted in the identification of potential mental health, sleep and allergy problems in both Olympic and Paralympic athletes. Strong associations between mental health and sleep disorders suggest these problems should be considered together in health screening programmes.
Exercise capacity is associated with hospital readmission among patients with diabetes
Authors: Zisman-Ilani Yaara , Fasing Kevin , Weiner Mark , Rubin Daniel J
Published: October 2020

Introduction

Patients with diabetes are at greater risk of hospital readmission than patients without diabetes. There is a need to identify more modifiable risk factors for readmission as potential targets for intervention. Cardiorespiratory fitness is a predictor of morbidity and mortality. The purpose of this study was to examine whether there is an association between exercise capacity based on the maximal workload achieved during treadmill stress testing and readmission among patients with diabetes.

Research design and methods

This retrospective cohort study included adult patients with diabetes discharged from an academic medical center between July 1, 2012 and December 31, 2018 who had a stress test documented before the index discharge. Univariate analysis and multinomial multivariable logistic regressions were used to evaluate associations with readmission within 30 days, 6 months, and 1 year of discharge. Exercise capacity was measured as metabolic equivalents (METs).

Results

A total of 580 patients with 1598 hospitalizations were analyzed. Mean METs of readmitted patients were significantly lower than for non-readmitted patients (5.7 (2.6) vs 6.7 (2.6), p<0.001). After adjustment for confounders, a low METs level (<5) was associated with higher odds of readmission within 30 days (OR 5.46 (2.22–13.45), p<0.001), 6 months (OR 2.78 (1.36–5.65), p=0.005), and 1 year (OR 2.16 (1.12–4.16), p=0.022) compared with medium (5–7) and high (>7) METs level. During the 6.5-year study period, patients with low METs had a mean of 3.2±3.6 hospitalizations, while those with high METs had 2.5±2.4 hospitalizations (p=0.007).

Conclusions

Lower exercise capacity is associated with a higher risk of readmission within 30 days, 6 months, and 1 year, as well as a greater incidence of hospitalization, in patients with diabetes. Future studies are needed to explore whether exercise reduces readmission risk in this population.
Genetic risk of obesity as a modifier of associations between neighbourhood environment and body mass index: an observational study of 335 046 UK Biobank participants
Authors: Mason Kate E , Palla Luigi , Pearce Neil , Phelan Jody , Cummins Steven
Published: October 2020

Background

There is growing recognition that recent global increases in obesity are the product of a complex interplay between genetic and environmental factors. However, in gene-environment studies of obesity, ‘environment’ usually refers to individual behavioural factors that influence energy balance, whereas more upstream environmental factors are overlooked. We examined gene-environment interactions between genetic risk of obesity and two neighbourhood characteristics likely to be associated with obesity (proximity to takeaway/fast-food outlets and availability of physical activity facilities).

Methods

We used data from 335 046 adults aged 40–70 in the UK Biobank cohort to conduct a population-based cross-sectional study of interactions between neighbourhood characteristics and genetic risk of obesity, in relation to body mass index (BMI). Proximity to a fast-food outlet was defined as distance from home address to nearest takeaway/fast-food outlet, and availability of physical activity facilities as the number of formal physical activity facilities within 1 km of home address. Genetic risk of obesity was operationalised by weighted Genetic Risk Scores of 91 or 69 single nucleotide polymorphisms (SNP), and by six individual SNPs considered separately. Multivariable, mixed-effects models with product terms for the gene-environment interactions were estimated.

Results

After accounting for likely confounding, the association between proximity to takeaway/fast-food outlets and BMI was stronger among those at increased genetic risk of obesity, with evidence of an interaction with polygenic risk scores (p=0.018 and p=0.028 for 69-SNP and 91-SNP scores, respectively) and in particular with a SNP linked toMC4R(p=0.009), a gene known to regulate food intake. We found very little evidence of gene-environment interaction for the availability of physical activity facilities.

Conclusions

Individuals at an increased genetic risk of obesity may be more sensitive to exposure to the local fast-food environment. Ensuring that neighbourhood residential environments are designed to promote a healthy weight may be particularly important for those with greater genetic susceptibility to obesity.
Maternal trauma due to motor vehicle crashes and pregnancy outcomes: a systematic review and meta-analysis
Authors: Amezcua-Prieto Carmen , Ross Jennifer , Rogozińska Ewelina , Mighiu Patritia , Martínez-Ruiz Virginia , Brohi Karim , Bueno-Cavanillas Aurora , Khan Khalid Saeed , Thangaratinam Shakila
Published: October 2020

Objectives

To systematically review and quantify the effect of motor vehicle crashes (MVCs) in pregnancy on maternal and offspring outcomes.

Design

Systematic review and meta-analysis of observational data searched from inception until 1 July 2018. Searching was from June to August 2018 in Medline, Embase, Web of Science, Scopus, Latin-American and Caribbean System on Health Sciences Information, Scientific Electronic Library Online, TRANSPORT, International Road Research Documentation, European Conference of Ministers of Transportation Databases, Cochrane Database of Systematic Reviews and Cochrane Central Register.

Participants

Studies were selected if they focused on the effects of exposure MVC during pregnancy versus non-exposure, with follow-up to verify outcomes in various settings, including secondary care, collision and emergency, and inpatient care.

Data synthesis

For incidence data, we calculated a pooled estimate per 1000 women. For comparison of outcomes between women involved and those not involved in MVC, we calculated ORs with 95% CIs. Where possible, we statistically pooled the data using the random-effects model. The quality of studies used in the comparative analysis was assessed with Newcastle–Ottawa Scale.

Results

We included 19 studies (3 222 066 women) of which the majority was carried out in high-income countries (18/19). In population-level studies of women involved in MVC, maternal death occurred in 3.6 per 1000 (95% CI 0.25–10.42; 3 studies, 12 000 women; Tau=1.77), and fetal death or stillbirth in 6.6 per 1000 (95% CI 3.81–10.12; 8 studies, 47 992 women; I2=92.6%). Pooled incidence of complications per 1000 women involved in MVC was labour induction (276.43), preterm delivery (191.90) and caesarean section (166.65). Compared with women not involved in MVC, those involved had increased odds of placental abruption (OR 1.43, 95% CI 1.27–1.63; 3 studies, 1 500 825 women) and maternal death (OR 202.27; 95% CI 110.60–369.95; 1 study, 1 094 559 women).

Conclusion

Pregnant women involved in MVC were at higher risk of maternal death and complications than those not involved.

PROSPERO registration number

CRD42018100788.
Measuring health literacy combining performance-based and self-assessed measures: the roles of age, educational level and financial resources in predicting health literacy skills. A cross-sectional study conducted in Florence (Italy)
Authors: Lorini Chiara , Lastrucci Vieri , Paolini Diana , Bonaccorsi Guglielmo
Published: October 2020

Objective

The objective was to compare the results of performance-based and self-assessed measures of health literacy (HL) and to evaluate the contribution of their joint use in assessing some HL antecedents.

Design

This was a cross-sectional study.

Setting

The study was conducted on the general population in Florence (Italy).

Participants

This study is part of a larger one, where participants were randomly selected from the registries of 11 general practitioners working in the municipality of Florence. Inclusion criteria were the following: 18–69 years of age and Italian speaking. Exclusion criteria included cognitive impairment, severe psychiatric disease or end-stage disease. In this paper, 212 adults were included.

Outcome measures

HL was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the Newest Vital Sign (NVS). The HL levels obtained by means of the two measurement tools were combined into a new variable that described three different levels of HL skills: low HL skills, partial HL skills and high HL skills. Multivariate ordinal logistic regression analysis was performed to assess the predictive roles of age class, educational level and financial resources with respect to HL skills.

Results

Twenty-two per cent of the sample had high HL skills, 28.3% had low HL skills and 49.5% had partial HL skills. Educational level, age class and financial resources were significantly associated with HL skills, with OR values being higher than those obtained using the NVS or the HLS-EU-Q16 individually.

Conclusion

The combination of the results obtained using the NVS and the HLS-EU-Q16 improves the understanding of HL. The new variable generated by this combination could be considered as a different way to assess HL and its multidimensional contents.
Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis
Authors: Sen Jonathan , Chung Erin , Neil Christopher , Marwick Thomas
Published: October 2020

Background

Hypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes.

Objective

To assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS.

Design

Systematic review and meta-analysis.

Data sources

The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019.

Study eligibility criteria, appraisal and synthesis methods

Two independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in R.

Main outcome measures

Mortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fraction

Results

From 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin–angiotensin–aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance.

Conclusion

AHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.
Validity of intraoperative imageless navigation (Naviswiss) for component positioning accuracy in primary total hip arthroplasty: protocol for a prospective observational cohort study in a single-surgeon practice
Authors: Ektas Nalan , Scholes Corey , Ruiz Alejandro M , Ireland John
Published: October 2020

Introduction

Optimal outcomes in total hip arthroplasty (THA) are dependent on appropriate placement of femoral and acetabular components, with technological advances providing a platform for guiding component placement to reduce the risk of malpositioned components during surgery. This study will validate the intraoperative data captured using a handheld imageless THA navigation system against postoperative measurements of acetabular inclination, acetabular version, leg length and femoral offset on CT radiographs.

Methods and analysis

This is a prospective observational cohort study conducted within a single-centre, single-surgeon private practice. Data will be collected for 35 consecutive patients (>18 years) undergoing elective THA surgery, from the research registry established at the surgeon’s practice. The primary outcome is the agreement between intraoperative component positioning data captured by the navigation system compared with postoperative measurements using CT. A total of ten CT scans will be reassessed for interobserver and intraobserver reliability. The influence of patient and surgical factors on the accuracy of component position will also be examined with multivariable linear regression.

Ethics and dissemination

Ethics approval for this study was provided through a certified ethics committee (Bellberry HREC approval number 2017-07-499). The results of this study will be disseminated through peer-reviewed journals and conference presentations.

Trial Registration

Australian and New Zealand Clinical Trials Registry (ANZCTR) Trial ID: ACTRN12620000089932.
Pronounced haemodynamic changes during and after robotic-assisted laparoscopic prostatectomy: a prospective observational study
Authors: Pawlik Michael T , Prasser Christopher , Zeman Florian , Harth Marion , Burger Maximilian , Denzinger Stefan , Blecha Sebastian
Published: October 2020

Objectives

Robotic-assisted laparoscopic prostatectomy (RALP) is typically conducted in steep Trendelenburg position (STP). This study investigated the influence of permanent 45° STP and capnoperitoneum on haemodynamic parameters during and after RALP.

Design

Prospective observational study.

Setting

Haemodynamic changes were recorded with transpulmonary thermodilution and pulse contour analysis in men undergoing RALP under standardised anaesthesia.

Participants

Informed consent was obtained from 51 patients scheduled for elective RALP in a University Medical Centre in Germany.

Interventions

Heart rate, mean arterial pressure, central venous pressure (CVP), Cardiac Index (CI), systemic vascular resistance (SVR), Global End-Diastolic Volume Index (GEDI), global ejection fraction (GEF), Cardiac Power Index (CPI) and stroke volume variation (SVV) were recorded at six time points: 20 min after induction of anaesthesia (T1), after insufflation of capnoperitoneum in supine position (T2), after 30 min in STP (T3), when controlling Santorini’s plexus in STP (T4), before awakening in supine position (T5) and after 45 min in the recovery room (T6). Adverse cardiac events were registered intraoperatively and postoperatively.

Results

All haemodynamic parameters were significantly changed by capnoperitoneum and STP during RALP and partly normalised at T6. CI, GEF and CPI were highest at T6 (CI: 3.9 vs 2.2 L/min/m²; GEF: 26 vs 22%; CPI: 0.80 vs 0.39 W/m²; p<0.001). CVP was highest at T4 (31 vs 7 mm Hg, p<0.001) and GEDI at T6 (819 vs 724 mL/m², p=0.005). Mean SVR initially increased (T2) but had decreased by 24% at T6 (p<0.001). SVV was highest at T5 (12 vs 9%, p<0.001). Two of the patients developed cardiac arrhythmia during RALP and one patient suffered postoperative cardiac ischaemia.

Conclusions

RALP led to pronounced perioperative haemodynamic changes. The combination of increased cardiac contractility and heart rate reflects a hyperdynamic situation during and after RALP. Anaesthesiologists should be aware of unnoticed pre-existing heart failure to worsen during STP in patients undergoing RALP.
Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis
Authors: Siedner Mark J , Kraemer John D , Meyer Mark J , Harling Guy , Mngomezulu Thobeka , Gabela Patrick , Dlamini Siphephelo , Gareta Dickman , Majozi Nomathamsanqa , Ngwenya Nothando , Seeley Janet , Wong Emily , Iwuji Collins , Shahmanesh Maryam , Hanekom Willem , Herbst Kobus
Published: October 2020

Objectives

We evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN).

Design

Observational cohort

Setting

Data were analysed from 11 primary healthcare clinics in northern KZN.

Participants

A total of 46 523 individuals made 89 476 clinic visits during the observation period.

Exposure of interest

We conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods.

Outcome measures

Daily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata.

Results

We found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI −16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (−7.1 visits/clinic/day, 95% CI −8.9 to 5.3), both for children aged <1 year and 1–5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8).

Conclusions

In rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.
Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
Authors: Stanford Gemma , Davies Jane C , Usmani Omar , Banya Winston , Charman Susan , Jones Mandy , Simmonds Nicholas J , Bilton Diana
Published: October 2020

Introduction

Airway clearance techniques (ACTs) are a gold standard of cystic fibrosis management; however, the majority of research evidence for their efficacy is of low standard; often attributed to the lack of sensitivity from outcome measures (OMs) used historically. This randomised controlled trial (RCT) investigates these standard OMs (sputum weight, forced expiratory volume in 1 s) and new OMs (electrical impedance tomography (EIT), multiple breath washout (MBW) and impulse oscillometry (IOS)) to determine the most useful measures of ACT.

Methods and analysis

This is a single-centre RCT with crossover design. Participants perform MBW, IOS and spirometry, and then are randomised to either rest or supervised ACT lasting 30–60 min. MBW, IOS and spirometry are repeated immediately afterwards. EIT and sputum are collected during rest/ACT. On a separate day, the OMs are performed with the other intervention. Primary endpoint is difference in change in OMs before and after ACT/rest. Sample size was calculated with 80% power and significance of 5% for each OM (target n=64).

Ethics and dissemination

Ethics approval was gained from the London–Chelsea Research Ethics Committee (reference 16/LO/0995, project ID 154635). Dissemination will involve scientific conference presentation and publication in a peer-reviewed journal.

Trial registration numbers

ISRCTN11220163andNCT02721498.
Association of smoking status with outcomes in hospitalised patients with COVID-19
Authors: Adrish Muhammad , Chilimuri Sridhar , Mantri Nikhitha , Sun Haozhe , Zahid Maleeha , Gongati Sudharsan , Fortuzi Ked , Jog Abhishrut Pramod , Purmessur Pravish , Singhal Ravish
Published: October 2020

Introduction

Smoking causes inflammation of the lung epithelium by releasing cytokines and impairing mucociliary clearance. Some studies have linked smoking with severity of illness of COVID-19 whereas others have found no such association.

Methods

This was a retrospective analysis of all adults hospitalised with COVID-19 from 9 March to 18 May 2020.

Results

1173 patients met the study criteria. 837 patients never smoked whereas 336 patients were either current smokers or past smoker and were grouped together in smokers group. Patients in smokers group were more likely to be male and had higher incidence of underlying chronic obstructive pulmonary disease (19% vs 6%, p<0.001), HIV infection (11% vs 5%,p<0.001), cancer (11% vs 6%, p=0.005), congestive heart failure (15% vs 8%, p<0.001), coronary artery disease (15% vs 9%, p=0.3), chronic kidney disease (11% vs 8%, p=0.037) and end-stage renal disease (10% vs 6%, p=0.009) compared with non-smokers. Outcome analysis showed that smokers were more likely to develop critical illness requiring mechanical ventilation (47% vs 37% p=0.005). Univariate Cox model for survival analysis by smoking status showed that among smokers only current smokers had higher risk of death compared with never smokers (HR 1.61, 95% CI 1.22 to 2.12, p<0.001). In the multivariate approach, Cox model for the survival, female sex, young age, low serum lactate dehydrogenase and systemic steroid use were associated with overall improved survival.

Conclusion

In our large single-centre retrospective database of patients hospitalised with COVID-19, smoking was associated with development of critical illness and higher likelihood of death.
T-cell agonists in cancer immunotherapy
Authors: Choi Yeonjoo , Shi Yaoyao , Haymaker Cara L , Naing Aung , Ciliberto Gennaro , Hajjar Joud
Published: October 2020

Cancer cells can evade immune surveillance in the body. However, immune checkpoint inhibitors can interrupt this evasion and enhance the antitumor activity of T cells. Other mechanisms for promoting antitumor T-cell function are the targeting of costimulatory molecules expressed on the surface of T cells, such as 4-1BB, OX40, inducible T-cell costimulator and glucocorticoid-induced tumor necrosis factor receptor. In addition, CD40 targets the modulation of the activation of antigen-presenting cells, which ultimately leads to T-cell activation. Agonists of these costimulatory molecules have demonstrated promising results in preclinical and early-phase trials and are now being tested in ongoing clinical trials. In addition, researchers are conducting trials of combinations of such immune modulators with checkpoint blockade, radiotherapy and cytotoxic chemotherapeutic drugs in patients with advanced tumors. This review gives a comprehensive picture of the current knowledge of T-cell agonists based on their use in recent and ongoing clinical trials.
Regulation of tumor growth by leukocyte-specific protein 1 in T cells
Authors: Kwon Riri , Hong Bong-Ki , Lee Kang-Gu , Choi Eunbyeol , Sabbagh Laurent , Cho Chul-Soo , Lee Naeun , Kim Wan-Uk
Published: October 2020

Background

Clinical efficacy of T cell-based cancer immunotherapy is limited by the lack of T cell infiltration in the tumor mass, especially in solid tumors. Our group demonstrated previously that leukocyte-specific protein 1 (LSP1), an intracellular signal regulator, negatively regulates T cell infiltration in inflamed tissues.

Methods

To determine the immuno-regulatory effects of LSP1 in T cells on tumor progression, we investigated the growth of B16 melanoma in Lsp1 knockout (KO) mice and T cell-specific Lsp1 transgenic (Tg) mice. The immune cell subpopulation infiltrated into the tumor mass as well as the expression of interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in T cells was assessed by flow cytometry and/or immunohistochemistry. Chemotactic migration was assayed with Lsp1 KO and Lsp1 Tg T cells. Adoptive transfer of Lsp1 KO or Lsp1 Tg T cells was performed in B16 melanoma-challenged Rag1 KO mice.

Results

Lsp1 KO mice showed decreased growth of B16 melanoma and increased infiltration of T cells in the tumor mass, which were completely reversed in T cell-specific Lsp1 Tg mice. Lsp1 KO CD8+ T cells also exhibited elevated migratory capacity in response to CXCL9 and CXCL10, whereas Lsp1 Tg CD8+ T cells did the opposite. LSP1 expression was increased in tumor-infiltrating T cells and could be induced by T cell receptor activation. Intriguingly, gene expression profiling of Lsp1 KO T cells suggested enhanced cytotoxicity. Indeed, expression of IFN-γ and TNF-α was increased in tumor-infiltrating CD4+ and CD8+ T cells of Lsp1 KO mice, while it was markedly reduced in those of Lsp1 Tg mice. Adoptive transfer of Lsp1 KO T cells to Rag1 KO mice was more effective in suppressing melanoma growth than transfer of Lsp1 Tg T cells. Of note, when treated with antiprogrammed cell death protein 1 (PD-1) antibody, inhibition of melanoma growth was more pronounced in Lsp1 KO mice than in Lsp1-sufficient mice, suggesting that Lsp1 depletion additively increases the antitumor effects of anti-PD-1 antibody.

Conclusions

LSP1 in T cells regulates the growth of B16 melanoma in mice, possibly by affecting migration and infiltration of T cells into the tumor and by modulating production of antitumor effector cytokines by CD8+ T cells. These findings provide evidence that LSP1 can be a target to improve the efficacy of T cell-based immunotherapy.
BISMICS consensus statement: implementing a safe minimally invasive mitral programme in the UK healthcare setting
Authors: Vohra Hunaid A , Salmasi M Yousuf , Chien Lueh , Caputo Massimo , Baghai Max , Deshpande Ranjit , Akowuah Enoch , Ahmed Ishtiaq , Tolan Michael , Bahrami Toufan , Hunter Steven , Zacharias Joseph
Published: October 2020

Disseminating the practice of minimally invasive mitral surgery (mini-MVS) can be challenging, despite its original case reports a few decades ago. The penetration of this technology into clinical practice has been limited to centres of excellence, and mitral surgery in most general cardiothoracic centres remains to be conducted via sternotomy access as a first line. The process for the uptake of mini-MVS requires clearer guidance and standardisation for the processes involved in its implementation. In this statement, a consensus agreement is outlined that describes the benefits of mini-MVS, including reduced postoperative bleeding, reduced wound infection, enhanced recovery and patient satisfaction. Technical considerations require specific attention and can be introduced through simulation and/or use in conventional cases. Either endoballoon or aortic cross clamping is recommended, as well as femoral or central aortic cannulation, with the use of appropriate adjuncts and instruments. A coordinated team-based approach that encourages ownership of the programme by the team members is critical. A designated proctor is also recommended. The organisation of structured training and simulation, as well as planning the initial cases, is an important step to consider. The importance of pre-empting complications and dealing with adverse events is described, including re-exploration, conversion to sternotomy, unilateral pulmonary oedema and phrenic nerve injury. Accounting for both institutional and team considerations can effectively facilitate the introduction of a mini-MVS service. This involves simulation, team-based training, visits to specialist centres and involvement of a designated proctor to oversee the initial cases.
Global Dynamics of an Elliptically Excited Pendulum Model
Authors: Zhou Liangqiang , Chen Fangqi
Published: October 2020

Using both analytical and numerical methods on the global dynamics, including the existence and uniqueness of solutions, subharmonic bifurcations and dynamic responses, of an elliptically excited pendulum model are investigated in this paper. The heteroclinic orbits, as well as periodic orbits with [Formula: see text] and [Formula: see text] types of unperturbed systems are obtained analytically. Chaotic vibrations arising from heteroclinic intersections are studied by means of the Melnikov method. The critical curves separating the chaotic and nonchaotic regions are plotted for different system parameters. The chaotic feature on the system parameter [Formula: see text], named the ratio between the horizontal and the vertical diameter of the upright ellipse traced out by the pivot during each period, is discussed in detail. The conditions for subharmonic bifurcations with the [Formula: see text] type or the [Formula: see text] type are also presented with the subharmonic Melnikov method. It is proved rigorously that the system can undergo chaotic motions through finite subharmonic bifurcations with the [Formula: see text] type. In addition, chaotic motions can occur through infinite subharmonic bifurcations with the [Formula: see text] type. An interesting dynamical phenomenon, i.e. “controllable frequency”, which decreases monotonically with the system parameter [Formula: see text], is presented. A number of related numerical simulations are given to confirm the analytical results.
CRIME AND FISCAL POLICY IN EUROPE: THE EFFECT OF SHADOW ECONOMY
Authors: GOULAS ELEFTHERIOS , KARIDIS SOCRATES
Published: October 2020

We empirically investigate the role of fiscal policies on criminal activity using a sample of 25 EU countries over the period 2000–2013. Our analysis indicates that tight fiscal policies appear to have a positive effect on crime. This effect becomes stronger when property (non-violent) crime rates are considered. Further, the presence of high levels of shadow economy in a country provides a very strong mitigating factor on the adverse effect of public policies on crime. The initially strong link between tight fiscal policy and non-violent crime weakens significantly in the presence of undocumented economic activities which compensate for the lack of formal economic opportunities.
Toward a Health Silk Road
Authors: Cao Jiahan
Published: October 2020

Originally designed as a component of the Belt and Road Initiative (BRI) under the pillar of people-to-people bonds, the Health Silk Road (HSR) has aroused intense interest and scrutiny amid the Covid-19 pandemic. Rather than a new geopolitical strategy within the BRI framework, the HSR is an emerging diplomatic initiative for promoting health cooperation in a world increasingly threatened by proliferating public health emergencies. China’s medical aid in the developing world before the HSR’s inception and broader health diplomacy since the onset of the coronavirus crisis have been misinterpreted in much of the developed world and some Asian neighbors. Although the HSR will be a bumpy road in a post-coronavirus era of growing geopolitical rivalry and fractured world market, the health cooperation initiative can still be built into a transregional health network to the benefit of nations concerned. To achieve this end, Beijing should take a two-pronged approach: building up a stronger and more resilient domestic health system and upgrading its multilayered partnerships with BRI participant nations and international organizations.
Effect of Music Training on the Production of English Lexical Stress by Chinese English Learners
Authors: Feng Hui , Lian Jie , Zhao Yingjie
Published: October 2020

In language acquisition, stress is one of the most prominent prosodic features of English. Previous studies have found that music training has a positive influence on second language acquisition. Under the guidance of the Theory of Multiple Intelligences, this study aims to find whether music training can improve English stress production among Chinese English learners without music background. Major findings are as follows: (1) Music training has a significant influence on the stress production by Chinese English learners. Specifically, after eight weeks of music training, there has been evident improvement in pitch and intensity in the training group in distinguishing stressed and unstressed syllables in disyllabic pseudowords. Besides, the accuracy of the production of unfamiliar words in the training group has increased by 11.5% on average, compared with that of the control group which has little change. In addition, little effect of music training on duration proportion in stressed syllables is found in this experiment. (2) Chinese English learners’ perception of music can be positively transferred to their production of English lexical stress. Such findings provide further proof for the effect of music training on the production of English lexical stress, and propose a method for Chinese English learners to improve their English pronunciation.
Comparing Different Thermal Runaway Triggers for Two Automotive Lithium-Ion Battery Cell Types
Authors: Essl C. , Golubkov A. W. , Fuchs A.
Published: October 2020

In order to understand the lithium-ion battery (LIB) failing behavior and to prevent failures and their consequences, different LIB safety tests, also called abuse tests, have been developed. This paper focuses on thermal runway (TR) triggered by overtemperature, overcharge and nail-penetration. It shows the setup and the results of the three different TR triggers on two different cell types in a custom-made TR reactor. The investigated cell types are state-of-the-art automotive pouch and hard case cells. The results are discussed in three main categories: thermal behavior, vent gas production and vent gas composition. The results and findings are supposed to be valuable for battery pack designer, car manufacturer and testing institutions for the development of future battery testing facilities and regulations.
A simulation of Gallium Indium Nitride Based Solar Cells
Authors: Wu Jin
Published: October 2020

InGaN can reach all values of bandgap from 3.42 to 0.7eV, which covers almost the entire solar spectrum. This study is to understand the influence of each parameter of the solar cell for an improved optimization of performance. The yield obtained for a reference cell is 12.2 % for optimal values of doping of the layers. For generation and recombination, performance of the cell varies with these settings. III nitrides have a high absorption coefficient, a very thin layers of material are sufficient to absorb most of the light.
Protocol of the Development of a Core Outcome Set for Ischemic Stroke in Clinical Trials of Chinese Medicine
Authors: Xie Qianwen , Deng Xueyi , Xiao Jingmin , Chen Xueyin , He Yihan , Yang Lihong , Liu Shaonan , Lai Jiaqi , Cai Yefeng , Sun Jingbo , Guo Xinfeng
Published: October 2020

Background. Ischemic stroke (IS) seriously impacts the quality of life of survivors. Chinese medicine (CM) has been developed for more than 2000 years and plays a key role in the treatment of ischemic stroke. Many Chinese medicine clinical trials have been conducted; however, the heterogeneity of outcome measurements and reporting limits implications of the findings in clinical practice and health policy development. Therefore, it is important to develop a core outcome set (COS) that should be used and reported in trials for ischemic stroke treated by Chinese medicine. This protocol describes the process of developing the IS‐CM‐COS. Methods and Analysis. The development of the COS will involve the following four steps: (1) A list of outcomes reported in the registered and published Chinese medicine trials of ischemic stroke will be extracted by conducting a systematic literature review. (2) An additional outcome list will be collected by semistructured interview to patients with ischemic stroke. (3) A two‐round Delphi survey will be performed to prioritize and condense the outcomes. (4) In the consensus meeting, a final recommended COS will be developed. Discussion. The COS could improve the reliability and consistency of outcome reporting. We hope that this IS‐CM‐COS will be used in the future Chinese medicine trials for the treatment of ischemic stroke and improve research quality. Trial Registration. This study was registered with the Core Outcome Measures in Effectiveness Trials Initiative (http://www.comet-initiative.org/studies/details/1282).
Development of Rocking Isolation for Response Mitigation of Elevated Water Tanks under Seismic and Wind Hazards
Authors: Alemzadeh Hassan , Shakib Hamzeh , Khanmohammadi Mohammad
Published: October 2020

Elevated water tanks are categorized as strategic components of water supply systems in modern urban management. Past earthquake events have revealed the high vulnerability of these structures. This paper investigates the development of rocking isolation (RI) to these structures as a response mitigation technique. Using an analytical approach, a dynamic model is developed for two isolation cases: (1) at the pedestal base and (2) under the tank. The model incorporates a simplified analogy for simulating the liquid-tank system which is modified for a tank under rocking motions. Based on the dynamics of rocking structures, the equations of motion, impact, and uplift transitions are derived. Then, free vibration and seismic response history analyses are carried out on a sample structure. Discussions are made on the effect of RI on the dynamic and seismic responses of the pedestal and components of the liquid-tank system. Effects of various RI cases, pedestal heights, and tank filling levels are studied for a group of structures excited by an ensemble of ground motions. Considering that the system may be vulnerable to other lateral loadings, the combined effects of seismic and wind hazards are also studied. The wind loads are assumed to act statically and simultaneously with the seismic excitations. Results show that the first case of RI decreases the acceleration demands of mid-rise and tall structures, thus lowering the structural demands to 50% of the fixed-base system. However, the second case of RI has almost no effect on the performance of the system, upgrading only the response of mid-rise structures. Both RI cases also aggravate the wave oscillations and increase the freeboard requirements. Finally, while the combined seismic and wind hazards have almost no effect on the operational performances, the force demands of the structures are increased by 10%.
Evaluation of Antibiotic Resistance Pattern in Dental Bacteremia Detected by Multiplex PCR Technique
Authors: Rezazadeh Fahimeh , Azad Azita , Khorami Ali , Modaresi Farzan , Rezaie Zahra
Published: October 2020

The aim of this study was to detect oral bacteremia and offer the antibiotic resistance patterns. Bacterial resistance pattern was evaluated in 50 patients. A spectrophotometer device equipped with UV and electrophoresis of the extracted samples on agarose gel for antibiogram test were used. PCR test 15 minutes after tooth extraction showed that bacterial strains were extracted from 16 patients. Lactobacillus, Enterococcus faecalis (E. faecalis), Streptococcus sanguinis (S. sanguinis), Streptococcus salivarius (S. salivarius), and Streptococcus mutans (S. mutans) were extracted from 5, 4, 4, 4, and 6 patients. 100% of Lactobacillus, E. faecalis, S. sanguinis, S. salivarius, and S. mutans were sensitive to tigecycline. Most of the Lactobacillus antibiotic resistance was against tetracycline and ciprofloxacin. Antibiotic resistance in S. salivarius was observed in 75% of the cases against piperacillin‐tazobactam, ciprofloxacin, and cefotaxime, while in S. mutans was 84% of the cases against ceftriaxone. The results of the current study showed that tooth extraction causes bacteremia before, during, and after tooth extraction. Generally, the highest antibiotic resistance occurred against tetracycline, ciprofloxacin, and ampicillin‐sulbactam. In most cases, the bacteria showed partial resistance to these antibiotics; however, tigecycline showed 100% efficacy on all types of bacteria. Streptococcus strains (salivarius, mutans, and sanguinis) were sensitive to most of the antibiotics while antibiotic sensitivity was less evident in Lactobacillus and E. faecalis. Antibiotic resistance has become a critical issue, since it leads to treatment failure when there is a need for antibiotic therapy.
A New Result on Tricyclic Mappings
Authors: Sabar Taoufik , Bassou Abdelhafid , Aamri Mohamed
Published: October 2020

In this note, we present a best proximity point theorem for tricyclic contractions in the setting of CAT(0) spaces. In the same context, we give an elaborate counterexample.
Application of Chromosome Microarray Analysis in the Investigation of Developmental Disabilities and Congenital Anomalies: Single Center Experience and Review of NRXN3 and NEDD4L Deletions
Authors: Çebi Alper Han , Altıner Şule
Published: October 2020

Chromosomal microarray analysis (CMA) is a first step test used for the diagnosis of patients with developmental delay, intellectual disability, autistic spectrum disorder, and multiple congenital anomalies. Its widespread usage has allowed genome-wide identification of copy number variations (CNVs). In our study, we performed a retrospective study on clinical and microarray data of 237 patients with developmental disabilities and/or multiple congenital anomalies and investigated the clinical utility of CMA. Phenotype-associated CNVs were detected in 15.18% of patients. Besides, we detected submicroscopic losses on 14q24.3q31.1 in a patient with speech delay and on 18q21.31q21.32 in twin patients with seizures. Deletions of NRXN3 and NEDD4L were responsible for the phenotypes, respectively. This study showed that CMA is a powerful diagnostic tool in this patient group and expands the genotype-phenotype correlations on developmental disabilities.