bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes and Spectrum of Major Neurovascular Events Among COVID-19 Patients: A 3-Center Experience
Authors: Taylor Blake E S , Khandelwal Priyank , Rallo Michael S , Patel Purvee , Smith Lindsey , Sun Hai , Nanda Anil , Singla Amit , Roychowdhury Sudipta , Cheng Roger C , Lee Kiwon , Gupta Gaurav , Johnson Stephen A
Published: July 2020

BACKGROUND

Preliminary data suggest that Coronavirus Disease-2019 (COVID-19) is associated with hypercoagulability and neurovascular events, but data on outcomes is limited.

OBJECTIVE

To report the clinical course and outcomes of a case series of COVID-19 patients with a variety of cerebrovascular events.

METHODS

We performed a multicentric, retrospective chart review at our three academic tertiary care hospitals, and identified all COVID-19 patients with cerebrovascular events requiring neuro-intensive care and/or neurosurgical consultation.

RESULTS

We identified 26 patients between March 1 and May 24, 2020, of whom 12 (46%) died. The most common event was a large-vessel occlusion (LVO) in 15 patients (58%), among whom 8 died (8/15, 53%). A total of 9 LVO patients underwent mechanical thrombectomy, of whom 5 died (5/9, 56%). A total of 7 patients (27%) presented with intracranial hemorrhage. Of the remaining patients, 2 had small-vessel occlusions, 1 had cerebral venous sinus thrombosis, and another had a vertebral artery dissection. Acute Respiratory Distress Syndrome occurred in 8 patients, of whom 7 died. Mortalities had a higher D-dimer on admission (mean 20 963 ng/mL) than survivors (mean 3172 ng/mL). Admission Glasgow Coma Scale (GCS) score was poor among mortalities (median 7), whereas survivors had a favorable GCS at presentation (median 14) and at discharge (median 14).

CONCLUSION

COVID-19 may be associated with hemorrhage as well as ischemia, and prognosis appears poorer than expected—particularly among LVO cases, where outcome remained poor despite mechanical thrombectomy. However, a favorable neurological condition on admission and lower D-dimer may indicate a better outcome.
Impact of Group Selection Silviculture on Timber Harvesting Productivity and Cost in Appalachian Hardwood Timber Stands
Authors: Shaffer Robert M. , Brummel Kenneth R. , Reisinger Thomas W. , Stokes Bryce J.
Published: July 2020

Group selection is a regeneration harvest method that is being promoted by the USDA Forest Service as an alternative to clearcutting. In a group selection cut, "groups" of trees are marked and harvested in small patches dispersed in a mosaic pattern throughout the timber stand. Group selection has the potential to increase harvesting cost as compared to traditional clearcutting. Three logging systems, a skyline yarder system, a feller-buncher/cable skidder system, and a chainsaw felling/cable skidder system were studied while logging group selection timber sales in the Jefferson National Forest in Virginia. Time study data on the felling and skidding functions were recorded, as well as weekly production and cost data for each operation. Historic clearcutting production was obtained from the study loggers' records for comparison purposes. Group selection unit costs were $39.72, $14.13, and $15.33 per ton for the three systems, respectively. The study systems experienced decreases in production ranging front 17% to 52%. Most of the production decrease was due to an excessive amount of unproductive time directly resulting from the impact of the small, dispersed, multiple-harvest areas on the loggers' normal operating procedure and work flow. North. J. Appl. For. 10(4): 170-174.
2295. Clinical Characteristics of Achromobacter Xylosoxidans Infections in a Korean Teaching Hospital
Authors: Hong Hyo-Lim , Ho Lee Kang
Published: July 2020

Background

Achromobacter species are non-fermentous Gram-negative bacilli that are primarily found in contaminated soil or water, but is rare in human. Although their low virulence, Achromobacter xylosoxidans is considered one of the emerging nosocomial agents in immunocompromised patients, including those with hematologic malignancy, diabetes, and renal failure. This organisms can cause pneumonia, catheter-related blood stream infection, urinary tract infection, and meningitis. We investigated the clinical manifestations and outcomes associated with A. xylosoxidans infection in a mid-sized community-based hospital in Korea.

Methods

We retrospectively analyzed all consecutive episodes of A. xylosoxidans in a mid-sized community-based hospital from October 2015 to April 2019.

Results

A total 181 clinical isolates of A. xylosoxidans were obtained from 123 patients. Of these, 117 (95%) had nosocomial infection that mostly received previous antibiotic therapy. A. xylosoxidans was isolated from respiratory tract (68%, 84/123), peritoneal fluid (11%, 13/123), urine (8%, 10/123) and blood (6%, 7/123). Seven cases of A. xylosoxidans bacteremia was associated with intravenous catheter sepsis. Seventy-eight cases (63%) had polymicrobial infection; P. aeruginosa (n = 21) was most commonly coisolates organisms, followed by S. maltophilia (n = 20) and methicillin-resistant S. aureus (n = 15). The main underlying diseases were neurologic disease (41%), diabetes mellitus (36%), and solid cancer (25%). Of these, 53 patients (43%) were categorized as in an immunocompromised state. The in-hospital mortality rate was 23%. Based on multivariate analysis, neurologic disease (hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 0.08–0.67; P = 0.007) and the age-adjusted Charlson comorbidity score (HR: 1.31% CI: 1.038–1.65; P = 0.02) were associated with increased mortality.

Conclusion

We concludes that, though rare, A. xylosoxidans could be pathogenic in immunocompromised patients who are in hospital. A. xylosoxidans can cause nosocomial infection and bacteremia is mostly originating from intravenous catheter. The potential impact on the clinical outcome, further investigations are required to delineate the role of A. xylosoxidans.

Disclosures

All authors: No reported disclosures.
720. Efficacy of Fosfomycin for Injection (FOS) vs. Piperacillin–Tazobactam (PIP-TAZ) in Adults with Complicated Urinary Tract Infection (cUTI) and Acute Pyelonephritis (AP): ZEUS Study Outcomes in Patients With Reduced Study Drug Susceptibility
Authors: Kaye Keith S , Das Anita F , Eckburg Paul B , Gelone Steven P , Schranz Jennifer , Ellis-Grosse Evelyn J
Published: July 2020

Background

FOS is being pursued for US registration in cUTI/AP. Safety and efficacy of FOS vs. PIP-TAZ were demonstrated in the noninferiority ZEUS trial in hospitalized patients with cUTI/AP. Although FOS resistance has been observed in several in vitro studies, resistance rates in clinical settings have remained relatively stable despite >40 years of clinical use of FOS outside of the United States. Here we report outcomes in patients who developed reduced susceptibility to study drug (FOS or PIP-TAZ) after enrollment in ZEUS.

Methods

Patients received IV FOS 6g q8h or PIP-TAZ 4.5g q8h for 7 days (no oral switch allowed). The primary endpoint was overall success (clinical cure + microbiologic eradication) in microbiologic modified intent-to-treat (m-MITT) population at test-of-cure (TOC; Day 19–21). Reduced susceptibility to FOS or PIP-TAZ was defined as a ≥4-fold increase from baseline in minimum inhibitory concentration (MIC) at Day 5, end of treatment (EOT; Day 7–8), TOC, or late follow-up (LFU; Day 26 ± 2). Microbiologic eradication/persistence of baseline and postbaseline pathogens was confirmed post hoc by pulsed-field gel electrophoresis (PFGE).

Results

In all m-MITT patients, overall success/clinical cure/microbiologic eradication rates (with PFGE) at TOC were 69.0/90.8/70.7% (FOS) and 57.3/91.6/60.1% (PIP-TAZ). Reduced study drug susceptibility was identified in 7/184 (3.8%) FOS and 8/178 (4.5%) PIP-TAZ patients; all had monomicrobial infections (Table 1). Of these patients, almost all were aged ≥50 years (93%), male (73%), white (100%), and had a screening diagnosis of cUTI (93%). At TOC, 7/7 FOS patients and 7/8 PIP-TAZ patients had microbiologic persistence but all patients were clinical cures; these responses were all sustained through LFU (Table 1).

Conclusion

In the ZEUS study, few patients had urine isolates with reduced postbaseline susceptibility to either FOS or PIP-TAZ. No trend was observed in isolate species associated with decreased susceptibility to FOS or PIP-TAZ, including various Enterobacteriaceae species and Pseudomonas aeruginosa. Despite microbiologic persistence at TOC in a small number of patients, all of these patients were clinical cures at TOC and sustained cures at LFU.

Disclosures

All authors: No reported disclosures.
0866 Does Obstructive Sleep Apnea Mediate the Relationship Between Post-Traumatic Stress Disorder and Low Back Pain in Veterans?
Authors: Taylor Kenneth A , Schwartz Skai W , Sebastião Yuri V , Anderson William McD , Foulis Phillip R
Published: July 2020

Introduction

Low back pain (LBP) is a common complaint among veterans, leading to notable limits in function, quality of life, and an increase in healthcare cost. The incidence and prevalence of LBP have been increasing in the veterans over the past several years. Obstructive sleep apnea (OSA) has been shown to be associated with LBP and there are notable associations among post-traumatic stress disorder (PTSD), OSA and LBP in this population.

Methods

A random sample of veterans stratified by quarter was taken between 2007 and 2011 (index date), collecting records from 2006 to 2016. Veterans were excluded if they had a prevalent case of LBP, and/or OSA in the year of or year before to their index date (index period), or PTSD, OSA and/or LBP prior to the index period. Associations among the PTSD, LBP, and OSA were calculated using SAS PROC LOGISTIC. SAS PROC PHREG was used to calculate hazard ratios (HR) for mediation analysis and the percent of 4-year LBP risk explained by OSA in those with PTSD.

Results

PTSD predicted LBP diagnosis (OR 1.52 [95% CI: 1.27, 1.83]) and OSA diagnosis (OR 2.06 [1.48, 2.88]). Additionally, OSA diagnosis was predictive of LBP diagnosis (OR 8.99 [95% CI: 7.07, 11.35]). The HR for the effect of PTSD on the risk LBP diagnosis was 1.47 (95% CI: 1.25, 1.74) without adjustment for OSA. The HR for the effect of PTSD on the risk LBP diagnosis adjusted for the mediator was 1.35 (95% CI: 1.15, 1.60). The resulting percent of excess LBP risk explained by OSA is 25.5% (95% CI: 19.6%,31.1%). All analyses were adjusted for potential confounders.

Conclusion

OSA may mediate a significant amount of the risk of LBP diagnosis in veterans with PTSD. Prevention of OSA among veterans with PTSD may significantly reduce the risk of future LBP in veterans with PTSD.

Support (If Any)

This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans’ Hospital.
NF-κB Signaling in Astrocytes Modulates Brain Inflammation and Neuronal Injury Following Sequential Exposure to Manganese and MPTP During Development and Aging
Authors: Hammond Sean L , Bantle Collin M , Popichak Katriana A , Wright Katie A , Thompson Delaney , Forero Catalina , Kirkley Kelly S , Damale Pranav U , Chong Edwin K P , Tjalkens Ronald B
Published: July 2020

Chronic exposure to manganese (Mn) is associated with neuroinflammation and extrapyramidal motor deficits resembling features of Parkinson’s disease. Activation of astrocytes and microglia is implicated in neuronal injury from Mn but it is not known whether early life exposure to Mn may predispose glia to more severe inflammatory responses during aging. We therefore examined astrocyte nuclear factor kappa B (NF-κB) signaling in mediating innate immune inflammatory responses during multiple neurotoxic exposures spanning juvenile development into adulthood. MnCl2 was given in drinking water for 30-day postweaning to both wildtype mice and astrocyte-specific knockout (KO) mice lacking I kappa B kinase 2, the central upstream activator of NF-κB. Following juvenile exposure to Mn, mice were subsequently administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) at 4 months of age. Animals were evaluated for behavioral alterations and brain tissue was analyzed for catecholamine neurotransmitters. Stereological analysis of neuronal and glial cell counts from multiple brain regions indicated that juvenile exposure to Mn amplified glial activation and neuronal loss from MPTP exposure in the caudate-putamen and globus pallidus, as well as increased the severity of neurobehavioral deficits in open field activity assays. These alterations were prevented in astrocyte-specific I kappa B kinase 2 KO mice. Juvenile exposure to Mn increased the number of neurotoxic A1 astrocytes expressing C3 as well as the number of activated microglia in adult mice following MPTP challenge, both of which were inhibited in KO mice. These results demonstrate that exposure to Mn during juvenile development heightens the innate immune inflammatory response in glia during a subsequent neurotoxic challenge through NF-κB signaling in astrocytes.
A Tiered Female Ovarian Toxicity Screening Identifies Toxic Effects of Checkpoint Kinase 1 Inhibitors on Murine Growing Follicles
Authors: Xu Jingshan , Wang Yingzheng , Kauffman Alexandra E , Zhang Yaqi , Li Yang , Zhu Jie , Maratea Kimberly , Fabre Kristin , Zhang Qiang , Woodruff Teresa K , Xiao Shuo
Published: July 2020

Ovarian toxicity (ovotoxicity) is one of the major side effects of pharmaceutical compounds for women at or before reproductive age. The current gold standard for screening of compounds’ ovotoxicity largely relies on preclinical investigations using whole animals. However, in vivo models are time-consuming, costly, and harmful to animals. Here, we developed a 3-tiered ovotoxicity screening approach starting from encapsulated in vitro follicle growth (eIVFG) and screened for the potential ovotoxicity of 8 preclinical compounds from AstraZeneca (AZ). Results from Tiers 1 to 2 screenings using eIVFG showed that the first 7 tested AZ compounds, AZ-A, -B, -C, -D, -E, -F, and -G, had no effect on examined mouse follicle and oocyte reproductive outcomes, including follicle survival and development, 17β-estradiol secretion, ovulation, and oocyte meiotic maturation. However, AZ-H, a preclinical compound targeting the checkpoint kinase 1 inhibitor to potentiate the anticancer effects of DNA-damaging agents, significantly promoted granulosa cell apoptosis and the entire growing follicle atresia at clinically relevant concentrations of 1 and 10 μM. The more targeted explorations in Tier 2 revealed that the ovotoxic effect of AZ-H primarily resulted from checkpoint kinase 1 inhibition in granulosa cells. Using in vivo mouse model, the Tier 3 screening confirmed the in vitro ovotoxicities of AZ-H discovered in Tiers 1 and 2. Also, although AZ-H at 0.1 μM alone was not ovotoxic, it significantly exacerbated gemcitabine-induced ovotoxicities on growing follicles. Taken together, our study demonstrates that the tiered ovotoxicity screening approach starting from eIVFG identifies and prioritizes pharmaceutical compounds of high ovotoxicity concern.
Point-of-Care Analysis of Neutrophil Phenotypes: A First Step Toward Immuno-Based Precision Medicine in the Trauma ICU
Authors: Spijkerman Roy , Hesselink Lillian , Bongers Suzanne , van Wessem Karlijn J.P. , Vrisekoop Nienke , Hietbrink Falco , Koenderman Leo , Leenen Luke P.H.
Published: July 2020

Objectives:

The amount of tissue damage and the amplitude of the immune response after trauma are related to the development of infectious complications later on. Changes in the neutrophil compartment can be used as read out of the amplitude of the immune response after trauma. The study aim was to test whether 24/7 point-of-care analysis of neutrophil marker expression by automated flow cytometry can be achieved after trauma.

Design:

A prospective cohort study was performed. Polytrauma patients who developed infectious complications were compared with polytrauma patients who did not develop infectious complications.

Setting:

The study was performed in a level 1 trauma center.

Patients:

All trauma patients presented in the trauma bay were included.

Interventions:

An extra blood tube was drawn from all patients. Thereafter, a member of the trauma team placed the blood tube in the fully automated flow cytometer, which was located in the corner of the trauma room. Next, a modified and tailored protocol for this study was automatically performed.

Main Results:

The trauma team was able to successfully start the point-of-care automated flow cytometry analysis in 156 of 164 patients, resulting in a 95% success rate. Polytrauma patients who developed infectious complications had a significantly higher %CD16dim/CD62Lbright neutrophils compared with polytrauma patients who did not develop infectious complications (p = 0.002). Area under the curve value for %CD16dim/CD62Lbright neutrophils is 0.90 (0.83–0.97).

Conclusions:

This study showed the feasibility of the implementation of a fully automated point-of-care flow cytometry system for the characterization of the cellular innate immune response in trauma patients. This study supports the concept that the assessment of CD16dim/CD62Lbright neutrophils can be used for early detection of patients at risk for infectious complications. Furthermore, this can be used as first step toward immuno-based precision medicine of polytrauma patients at the ICU.
The Get-Up! study: adiposity and blood pressure in Australian toddlers
Authors: Sousa-Sá Eduarda , Zhang Zhiguang , Pereira João R. , Veldman Sanne L.C. , Okely Anthony D. , Santos Rute
Published: July 2020

Background:

Because the elevated blood pressure (BP) in childhood is strongly associated with overweight and is a risk factor for later cardiovascular disease, a need to comprehend the early development of BP and its association with overweight is needed. We assessed differences of BP by weight status in Australian toddlers.

Methods:

From the Get-Up! Study in Australia, this sample included 265 toddlers (136 boys), aged 19.6 ± 4.2 months. BP was measured with a digital vital signs monitor. Participants were categorized as nonoverweight and overweight according to the World Health Organization definition for body mass index (BMI). Physical activity was captured with activPAL accelerometers, during childcare hours. To test differences in BP between nonoverweight and overweight children, we performed an analysis of covariance adjusting for sex, age, physical activity, and socioeconomic status.

Results:

Children with overweight showed higher z systolic BP values (P = .042 for BMI and P = .023 for waist circumference) when compared to nonoverweight children. However, no differences were found for z diastolic BP levels, between overweight and nonoverweight children. After adjustments for potential confounders (socioeconomic status, physical activity, sex, and age), there were no significant differences in BP variables between BMI and waist circumference groups.

Conclusions:

No associations between adiposity and BP levels were found in this sample. The unadjusted results, however, showed that children with higher levels of adiposity (BMI and waist circumference) exhibited higher levels of BP. Additional research is needed to determine which environmental and genetic factors might contribute to pediatric hypertension, particularly among toddlers.
Diagnosis, treatment, and work impact of iron deficiency anemia in a Portuguese urban community
Authors: Norton Pedro , Araújo Natália , Pinho Paulo , Costa Gomes Joana , Silva Carla , Gama Céline , Barbosa Manuel , Ferreira Pedro , Cunha Sara , Moreira Sara , Martins Sílvia , Faria Sofia , Sousa Sophie , Figueiras Alves Nuno , Lunet Nuno
Published: July 2020

Introduction:

Little is known about iron deficiency anemia (IDA)'s treatment in Portugal. We aim to estimate the proportion of anemia, IDA, and iron deficiency without anemia; characterize the diagnostic procedures and prescription patterns; assess anemia's impact over work absenteeism, in a Local Health Unit.

Material and methods:

Cross-sectional study that evaluated complete blood counts, iron-containing prescriptions, comorbidities, economic failure, and disability certificates issued in 2015 at the Local Health Unit.

Results:

We evaluated 62,794 complete blood count. The proportion of anemia was 16.5%, higher in patients with economic failure, pregnant women, and patients with congestive heart failure. Of the patients with anemia 87.8% had not serum iron and/or ferritin dosing, and of those with serum iron/ferritin levels tested 50.6% had IDA. IDA was higher in pregnant women, women aged ≥15 years and in patients with congestive heart failure. Approximately 56.2% of patients with IDA did not receive iron-containing medication, and in 38% of the cases the prescribed dose was subtherapeutic. Of the total iron prescriptions 44.1% were association therapies. Anemia accounted for 5.2% of the disability certificates issued in 2015 (1749 workdays lost).

Discussion:

Most patients with anemia are not being adequately evaluated and a major proportion does not undergo treatment or has subtherapeutic doses of iron. These results may explain the anemia's impact on work capacity.

Conclusion:

This is one of the largest studies on anemia in Portugal. An effort to adapt to the established recommendations is urged, to minimize the consequences of this disease.
Reproductive trajectories and social-biological dimensions in parenthood: Portuguese version of the Meaning of Parenthood scale
Authors: Henriques Ana , Samorinha Catarina , Ramos Elisabete , Silva Susana
Published: July 2020

Background:

Public meanings attributed to parenthood may shape individuals’ family planning and how involuntary childlessness is supported by governmental policies. This study aimed to evaluate the influence of reproductive trajectories and gender in the meanings attributed to parenthood, and to assess the psychometric characteristics of the Portuguese version of the Meaning of Parenthood (MOP) scale.

Methods:

The sample comprised 754 participants: 246 young adults without children; 51 fathers and 159 mothers of adolescent children conceived spontaneously; and 149 infertile heterosexual couples. The scale was self-administered. Higher scores indicate attributing greater importance to parenthood to fulfill identity needs at individual, marital and social levels. Psychometric characteristics were analyzed through exploratory factor analysis; Cronbach alpha (α) assessed internal consistency.

Results:

Two dimensions of the MOP scale emerged, with good internal consistency (α ≥ 0.70): biological (importance of parenthood to fulfill reproductive needs as a biological being); social (importance of parenthood arising from social reproduction). Young adults attributed less importance to parenthood to fulfill both biological and social needs. The biological dimension was valued more than the social dimension in all subsamples; men highly valued the biological dimension compared to women.

Conclusions:

Family planning needs to focus on a reasonable balance between biological and social dimensions of parenthood. The reinforcement of public policies providing the necessary conditions for human reproduction is essential to reverse declining fertility rates.
Is the Newborn Microbiome Disrupted by Routine Newborn Suctioning? An Exploratory Approach for Policy Development
Authors: O'Neal Pamela V. , Adams Ellise D.
Published: July 2020

An invasive procedure commonly used in the perinatal setting is newborn suctioning at birth. Routine newborn suctioning, without indication, is not recommended by the American Academy of Pediatrics, the American Heart Association, and the European Resuscitation Council for the newborn with spontaneous respirations, adequate crying, and good muscle tone. Whether to suction a newborn is a difficult practice decision made daily by the perinatal nurse. A primary element of this practice decision is the consideration that newborn suctioning has the potential to affect health outcomes. Furthermore, routine newborn suctioning may be disrupting the newborn microbiome by removing commensal bacteria and potentially, negatively affecting newborn health. This article will explore the connection between the practice of routine newborn suctioning in the perinatal setting and the potential to disrupt the newborn microbiome. The methods employed and reported in this article consisted of review of literature and review of clinical guidelines and a descriptive study to determine the scope of practice of newborn suctioning. The premise of whether the practice of routine newborn suctioning at birth may be disrupting the newborn microbiome will also be considered. Finally, developing a microbiome-centric perspective will be explored.
Efficacy of fulvestrant 500 mg in Chinese postmenopausal women with advanced/recurrent breast cancer and factors associated with prolonged time-to-treatment failure
Authors: Huang Jian , Huang Ping , Shao Xi-ying , Sun Yan , Lei Lei , Lou Cai-jin , Ye Wei-wu , Chen Jun-qing , Cao Wen-ming , Huang Yuan , Zheng Ya-bing , Wang Xiao-jia , Chen Zhan-hong
Published: July 2020

This study was to investigate the efficacy and safety of fulvestrant 500 mg for the treatment of hormone receptor positive advanced postmenopausal women, including ovarian ablation and investigated factors associated with prolonged time-to-treatment failure.

Data from 60 women with metastatic breast cancer who were treated at Zhejiang Cancer Hospital. Patients received 500 mg (n = 60) between December 2011 and November 2012 were followed until November 2017. Main outcomes were clinical responses to fulvestrant, including best response, progressive disease, partial response, and stable disease lasting 12 months or more. Time to progression and time to progression-free-survival were also analyzed.

Among the included 60 patients (mean age 47.18 years), 51 (85.0%) had received prior adjuvant therapy. During follow-up after fulvestrant treatment, the median PFS for the best response was derived as 7.0 months (inter-quartile = 4, 13.8 months). The observed median progression-free-survival time for best response was represented longer when fulvestrant was first-line treatment than when patients received prior endocrine and/or chemotherapy. Univariate analysis revealed that receiving either endocrine therapy only or endocrine therapy plus chemotherapy prior to fulvestrant treatment may be associated with median progression-free survival time to best response (P = .002, .026, .007, respectively).

Fulvestrant treatment is safe and well-tolerated in women with hormone-sensitive advanced breast cancer, and first-line fulvestrant therapy increases progression-free-survival time, especially in patients without prior adjuvant treatment.
Association of RANTES gene polymorphisms with susceptibility to childhood asthma
Authors: Zhang Yan-Qin , Gao Xiu-Xiang
Published: July 2020

Background:

Previous investigations have illustrated that regulated upon activation, normal T-cell expressed and secreted (RANTES) polymorphisms are linked to susceptibility to childhood asthma; nevertheless, the findings continue to be controversial. Accordingly, we conducted the present meta-analysis to clarify the impact of RANTES genetic polymorphisms (-403G/A and -28C/G) on childhood asthma vulnerability.

Methods:

A search for published literature was performed using the PubMed, EMBASE, Chinese National Infrastructure, Cochrane Library, Scopus, Web of Science, and WanFang databases and selected in the form of PICOS (participants, interventions, comparisons, outcomes, and study design) to identify all eligible research works. The link between RANTES genetic polymorphisms and childhood asthma susceptibility was evaluated by a pooled odds ratio with a 95% confidence interval.

Results:

In total, 14 case–control studies were included in the analysis. No significant association existed between risk of childhood asthma and the -403G/A polymorphism subjected to any genetic framework in the overall population. In the stratified analysis, according to ethnicity, the -403G/A polymorphism was linked to augmented vulnerability to childhood asthma in Caucasians (allelic model: odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.04–2.57,P = .034; codominant model: OR = 2.20, 95% CI = 1.28–3.78,P = .004; dominant model: OR = 1.78, 95% CI = 1.01–3.13,P = .047; and recessive model: OR = 1.92, 95% CI = 1.11–3.30,P = .019). For the stratified analysis by atopic status, the -403G/A polymorphism was linked to augmented childhood asthma in the codominant (OR = 1.39, 95% CI = 1.02–1.91,P = .037) and dominant models (OR = 1.43, 95% CI = 1.02–2.01,P = .037) in atopic asthma. For the -28C/G polymorphism, there was a significant association between childhood asthma and the -28C/G variant (allelic model: OR = 1.33, 95% CI = 1.08–1.65,P = .009; codominant framework: OR = 2.14, 95% CI = 1.47–3.10,P < .001; dominant model: OR = 1.44, 95% CI = 1.07–1.93,P = .017; and recessive model: OR = 2.08, 95% CI = 1.44–3.02,P < .001). Stratified analysis based on ethnicity and the -28C/G polymorphism was linked to augmented vulnerability to childhood asthma in Asian and Caucasian populations. For the subgroup analysis by atopic status, no association was found in atopic and non-atopic asthma.

Conclusion:

The present meta-analysis indicated that the RANTES -403G/A and -28C/G polymorphisms contributed to the development of childhood asthma.
A protocol of systematic review and meta-analysis of Mozart's Music for drug-resistant epilepsy
Authors: Wang Ke-Jian , Zhang Shi-Hua , Yu Jia-Nan , Sun Guang-Tao , Dong Shu-Xin
Published: July 2020

Background:

This study will aim to assess the effectiveness of Mozart's Music (MM) for the management of patients with drug-resistant epilepsy (DRE).

Methods:

In this study, we will search MEDLINE, EMBASE, Cochrane Library, Web of Science, CINAHL, Chinese Scientific Journal Database Information, WANGFANG, and China National Knowledge Infrastructure from their inauguration to March 1, 2020 without language and publication time restrictions. We will also identify other literature resources, such as reference lists of any related reviews. Trial quality will be examined by Cochrane risk of bias tool; reporting bias will be identified by a funnel plot and Egger test; and statistical analysis will be undertaken by RevMan 5.3 software.

Results:

This study will summarize high quality randomized controlled trials to appraise the effectiveness and safety of MM for the treatment of patients with DRE.

Conclusions:

The findings of this study will supply evidence to judge whether MM is effective on DRE at evidence-based medicine level.

Study registration number:

CRD42020170512.
CT imaging and pathological basis of linear shadow connecting pulmonary segmental artery to horizontal fissure
Authors: Guan Chun-Shuang , Yan Shuo , Lv Zhi-Bin , Sun Lei , Ma Da-Qing , Zhang Yan-Song , Xie Ru-Ming , Chen Bu-Dong
Published: July 2020

To investigate the computed tomography (CT) imaging and pathological basis of the linear shadows connecting pulmonary segmental arteries to horizontal fissure (hereinafter referred to as “linear shadow”) on thin-slice CT.

Collect 127 clinical cases to analyze the display and morphology of linear shadows on the thin-slice CT and to measure their length, thickness, and angle. Collect 11 autopsy specimens of coal worker's pneumoconiosis to conduct an imaging and pathology basis control study for the linear shadows.

There is no correlation between the linear shadow and gender, age, and smoking history. Linear shadows are observed in 54.33% of patients. 93.33% of those linear shadows are straight lines. Generally, the lengths are less than 10 mm, the thicknesses are around 1 mm, and the scopes of angles are wide, range from acute angles to obtuse angles. The linear shadow is a banded structure consisting of loose connective tissue, small blood vessels, and small lymphatic vessels due to the visceral pleura recessed and fused into the lung.

Linear shadows are intrinsic to the lung. The linear shadows consist of loose connective tissue, small blood vessels, and small lymphatic vessels.
COVID-19 national lockdown in Morocco: impacts on air quality and public health
Authors: Khomsi Kenza , Najmi Houda , Amghar Hassan , Chelhaoui Youssef , Souhaili Zineb
Published: July 2020

On the 20th April 2020, the end date of the first strict lockdown period in Morocco, 2 403 410 cases of the corona Virus were confirmed globally. The number of Morocco confirmed cases attended 2990, while 12 746 were suspected and 143 deaths were recorded. Due to the pandemic of coronavirus disease 2019 worldwide and in Morocco, almost all avoidable activities in the country were prohibited since the kingdom announced activities reduction on March 16, 2020 and then general lockdown with reduced industrial activities on March 20, 2020.

This study aims at comparing the air quality status in Casablanca and Marrakech, two large cities from Morocco, before the pandemic and during the lockdown situation to show whether COVID-19 compelled-anthropogenic activities lockdown may have saved lives by restraining ambient air pollution than by preventing infection.

We found that, during the quarantine, NO2 dropped by -12 μg/m3 in Casablanca and -7 μg/m3 in Marrakech. PM2·5 dropped by -18 μg/m3 in Casablanca and -14 μg/m3 in Marrakech. CO dropped by -0.04 mg/m3 in Casablanca and -0.12 mg/m3 in Marrakech. This air pollution reduction had created human health benefits and had reduced mortality and saved lives mainly from cardiovascular diseases.
Mass Generation, Neuron Labelling and 3D Imaging of Minibrains
Authors: Govindan Subashika , Batti Laura , Osterop Samira F , Stoppini Luc , Roux Adrien
Published: July 2020

Minibrain is a sphericalin vitro3D brain organoid model, composed of a mixed population of neurons and glial cells, generated from human iPSC derived neural stem cells. Despite the advances in human brain organoid models, there is a lack of labelling and imaging methodologies to characterize these models. In this study, we present a step-by-step methodology to generate human minibrain nurseries and novel strategies to subsequently label projection neurons, perform immunohistochemistry and 3D imaging of the minibrains at large multiplexable scales. To visualize projection neurons, we adapt viral transduction and to visualize the organization of cell types we implement immunohistochemistry. To facilitate 3D imaging of minibrains, we present here pipelines and accessories for one step mounting and clearing suitable for confocal microscopy. The pipelines are specifically designed in such a way that the assays can be multiplexed with ease for large-scale screenings using minibrains. Using the pipeline, we present i. dendrite morphometric properties obtained from 3D neuron morphology reconstructions and ii. distribution and quantification of cell types in 3D across whole mount organoids.
Comparison of predication of Acute Kidney Injury after cardiac surgery by health care providers versus the biomarker [TIMP-2]*[IGFBP7] and scoring systems. Protocol for a prospective single center observational study (PREDICTAKI)
Authors: Vandenberghe Wim , Van Laethem Lien , Zarbock Alexander , Meersch Melanie , Hoste Eric A.J.
Published: July 2020

Introduction

Acute kidney injury occurs in up to one third of patients after cardiac surgery and is an important contributor for adverse outcome. Previous research has demonstrated the benefit of a bundle of preventive measurements to reduce AKI in a subgroup of patients with high risk for AKI development. Urinary stress biomarkers [TIMP-2]*[IGFBP7] are used to identify these patients who are at risk for AKI. The trial aims to investigate the potential discrepancy between biomarker results and clinical estimation of occurrence of AKI on ICU in clinical practice.

Methods and analysis

We plan to include 100 adult patients after cardiac surgery with cardiopulmonary bypass in a prospective, single center clinical trial. After cardiac surgery, different type of healthcare professional in ICU will provide a prediction of AKI occurrence and severity in the next 48 hours by filling in a questionnaire just before and after [TIMP-2]*[IGFBP7] biomarker analysis. Primary, this trial investigates the potential discrepancy in AKI prediction between clinical estimation by healthcare providers, biomarker results, and previous described score systems. Secondly, the impact of knowledge of the biomarker result on the quality of prediction by healthcare providers will be evaluated.

Ethics and dissemination

This prospective, single center study has been approved by the medical ethical committee of the Ghent University Hospital (28th May 2019, trial registration number B670201939991). Informed consent was obtained for patients and healthcare providers.

Summary strength and limitations

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Influence of knowledge of a kidney biomarker on healthcare providers’ assessment of risk for AKI in clinical setting

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Different types of healthcare providers with various expertise

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It is a single center study with limited number of patients
SARS-CoV-2 infection induces robust, neutralizing antibody responses that are stable for at least three months
Authors: Wajnberg Ania , Amanat Fatima , Firpo Adolfo , Altman Deena R. , Bailey Mark J. , Mansour Mayce , McMahon Meagan , Meade Philip , Mendu Damodara Rao , Muellers Kimberly , Stadlbauer Daniel , Stone Kimberly , Strohmeier Shirin , Aberg Judith , Reich David L. , Krammer Florian , Cordon-Cardo Carlos
Published: July 2020

SARS-CoV-2 has caused a global pandemic with millions infected and numerous fatalities. Questions regarding the robustness, functionality and longevity of the antibody response to the virus remain unanswered. Here we report that the vast majority of infected individuals with mild-to-moderate COVID-19 experience robust IgG antibody responses against the viral spike protein, based on a dataset of 19,860 individuals screened at Mount Sinai Health System in New York City. We also show that titers are stable for at least a period approximating three months, and that anti-spike binding titers significantly correlate with neutralization of authentic SARS-CoV-2. Our data suggests that more than 90% of seroconverters make detectible neutralizing antibody responses and that these titers are stable for at least the near-term future.

One Sentence Summary

Antibody responses induced by natural mild-to-moderate SARS-CoV-2 infection are robust, neutralizing and are stable for at least 3 months.
Comparative Effectiveness of Knowledge Graphs- and EHR Data-Based Medical Concept Embedding for Phenotyping
Authors: Lee Junghwan , Liu Cong , Kim Jae Hyun , Butler Alex , Shang Ning , Pang Chao , Natarajan Karthik , Ryan Patrick , Ta Casey , Weng Chunhua
Published: July 2020

Objective

Concept identification is a major bottleneck in phenotyping. Properly learned medical concept embeddings (MCEs) have semantic meaning of the medical concepts, thus useful for feature engineering in phenotyping tasks. The objective of this study is to compare the effectiveness of MCEs learned by using knowledge graphs and EHR data for facilitating high-throughput phenotyping.

Materials and Methods

We investigated four MCEs learned from different data sources and methods. Knowledge-graphs were obtained from the Observational Medical Outcomes Partnership (OMOP) common data model. Medical concept co-occurrence statistics were obtained from Columbia University Irving Medical Center’s (CUIMC) OMOP database. Two embedding methods, node2vec and GloVe, were used to learn embeddings for medical concepts. We used phenotypes with their corresponding concepts generated and validated by the Electronic Medical Records and Genomics (eMERGE) network to evaluate the performance of learned MCEs in identifying phenotype-relevant concepts.

Results

Precision@k% and Recall@k% in identifying phenotype-relevant concepts based on a single concept and multiple seed concepts were used to evaluate MCEs. Recall@500% and Precision@500% based on a single seed concept of MCE learned using the enriched knowledge graph were 0.64 and 0.13, compared to Recall@500% and Precision@500% of MCE learned using the hierarchical knowledge graph (0.61 and 0.12), 5-year windowed EHR (0.51 and 0.10), and visit-windowed EHR (0.46 and 0.09).

Conclusion

Medical concept embedding enables scalable identification of phenotype-relevant medical concepts, thereby facilitating high-throughput phenotyping. Knowledge graphs constructed by hierarchical relationships among medical concepts learn more effective MCEs, highlighting the need of more sophisticated use of big data to leverage MCEs for phenotyping.
Psychotic-like experiences and polygenic liability in the ABCD Study®
Authors: Karcher Nicole R. , Paul Sarah E. , Johnson Emma C. , Hatoum Alexander S. , Baranger David AA , Agrawal Arpana , Thompson Wesley K. , Barch Deanna M. , Bogdan Ryan
Published: July 2020

Background

Psychotic-like experiences (PLEs) during childhood are harbingers for severe psychopathology, including psychotic disorders, and neurodevelopmental impairments in adolescence and adulthood.

Methods

Data from children of genomically-confirmed European ancestries (n=4,650; ages 9-10; 46.8% female) who completed the baseline Adolescent Brain Cognitive Development⍰ Study session were used to assess whether PLEs (i.e., both total and the presence of significantly distressing) are associated with polygenic scores (PGS) related to psychopathology (i.e., schizophrenia [SCZ], educational attainment [EDU], psychiatric cross-disorder risk [CROSS], PLEs). We also assessed whether variability in global and region indices of brain structure (i.e., volume, cortical thickness, surface area) as well as behaviors proximal to PGS (e.g., cognition for EDU) indirectly linked PGS to PLEs using mediational models.

Findings

EDU and CROSS PGS were associated with total and significantly distressing PLEs (all %ΔR2s=0.202-0.660%; ps<0.002). Significantly distressing PLEs were also associated with higher SCZ and PLEs PGS (both %ΔR2=0.120-0.171%; ps<0.02). Global brain volume metrics and cognition indirectly linked EDU PGS to PLEs (proportion mediated: 3.33-32.22%).

Interpretation

Total and distressing PLEs were associated with genomic risk indices associated with broad spectrum psychopathology risk (i.e., EDU and CROSS PGS). Significantly distressing PLEs were associated with genomic risk for psychosis (i.e., SCZ, PLEs). Global brain volume metrics and PGS-proximal behaviors represent promising putative intermediary phenotypes that may contribute to genomic risk for psychopathology. Broadly, polygenic scores derived from genome-wide association studies of adult samples can generalize to indices of psychopathology risk among children and aid the identification of putative neural and behavioral intermediaries of risk.

Funding

National Institute of Health
Serological Cytokine and chemokine profile in pregnant women with COVID19 in Mexico City
Authors: Cerbulo-Vazquez Arturo , Zavala-Barrios Berenice , Briones-Garduno Jesus Carlos , Guerrero-Avendano Guadalupe Mercedes Lucia , Arriaga-Pizano Lourdes , Ferat-Osorio Eduardo , Cabrera-Rivera Graciela Libier , Miranda-Cruz Patricia , Garcia de la Rosa Maria Teresa , Prieto-Chavez Jessica Lakshmi , Rivero-Arredondo Vanessa , Madera-Sandoval Ruth , Cruz-Cruz Alonso , Salazar-Rios Enrique , Serrano-Molina David , De Lira-Barraza Roberto , Villanueva-Compean Abel Humberto , Esquivel-Pineda Alejandra , Ramirez-Montes de Oca Ruben , Flores-Padilla Guillermo , Lopez-Macias Constantino
Published: July 2020

On January 30th, 2020, the WHO declared the outbreak of COVID19, a disease due to the new coronavirus called SARS-CoV-2. Certain comorbidities, symptoms and signs are characteristic of COVID19 in the general population and in pregnant women. However, pregnant women are considered as a high-risk group for COVID19. To know about the frequency of comorbidities, signs and symptoms, the presence of lymphopenia, antibodies response to SARS-CoV2 and cytokine and chemokine serum concentration, six pregnant women with COVID19 were studied at the moment of admission. The lower concentration of CCL17 was detected in the Pregnant COVID19 group, similar concentration of IL-6 was also detected in non-pregnant and pregnant COVID19 patients. Our result show that pregnant and non-pregnant women with COVID19 has similar cytokine profile.
Preparedness, Perceived Impact and Concerns of health Care Workers in a Teaching Hospital during Coronavirus Disease 2019 (COVID-19)
Authors: Saurabh Kumar , Ranjan Shilpi
Published: July 2020

Objective

Coronavirus Disease 2019 is a new threat to human lives worldwide. Preparedness of institutions during epidemic outbreak has a pivotal role in saving lives and preventing further spread. At the same time, these pandemics impact badly on professional and personal life of Health care workers. The objective of this study is to find the opinion of Health care workers regarding their level of preparedness, concerns and perceived impact related to this pandemic outbreak.

Materials and Methods

in this study, random samples of doctors and nurses was provided with a self-administered questionnaire regarding their preparedness, work and non-work related concerns and impact on their lives during Covid-19 outbreak.

Results

Most of the Health Care Workers believed that their institute preparation to fight Covid-19 pandemic is better than prior to onset of this crisis (p⍰0.001). Work related stress was seen more commonly in nurses whereas higher frequency of non-work related stress was observed among doctors. Nurses (75.55%) faith in their employer was more than doctors faith (46.66%) regarding their medical needs. There was more acceptance of hydroxychloroquine as a prophylactic drug for Covid-19 in doctors compared to nurses (p ⍰0.01).

Conclusions

Though this institute was more prepared at the time of pandemic spread, substantial opportunity of improvement remains. The consistency of work and non work related anxiety and stress in health care workers is very high in present study group. Concerns and risks of Health Care Workers should be addressed ethically and adequately by strengthening safety measures and building trust in the system they work.