bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemorrhage Expansion After Pediatric Intracerebral Hemorrhage
Authors: Boulouis Gregoire , Hak Jean-François , Kerleroux Basile , Benichi Sandro , Stricker Sarah , Gariel Florent , Alias Quentin , Bourgeois Marie , Meyer Philippe , Kossorotoff Manoelle , Garzelli Lorenzo , Garcelon Nicolas , Boddaert Nathalie , Morotti Andrea , Blauwblomme Thomas , Naggara Olivier
Published: January 2021

Background and Purpose:

Significant hemorrhage expansion (sHE) is a known predictor of poor outcome after an intracerebral hemorrhage (ICH) in adults but remains poorly reported in children. In a large inception cohort, we aimed to explore the prevalence of sHE, its associations with clinical outcomes, and its clinical-imaging predictors in children.

Methods:

Children admitted between January 2000 and March 2020 at a quaternary care pediatric hospital were screened for inclusion. Sample was restricted to children with 2 computed tomography scans within 72 hours of ICH onset, and a minimal clinical follow-up of months. sHE was defined as an increase from baseline ICH volume by 6 cc or 33% on follow-up computed tomography. Clinical outcome was assessed at 12 months with the King’s Outcome Scale for Childhood Head Injury score and defined as favorable for scores ≥5.

Results:

Fifty-two children met inclusion criteria, among which 8 (15%) demonstrated sHE, and 18 (34.6%) any degree of expansion. Children with sHE had more frequent coagulation disorders (25.0% versus 2.3%;
P
=0.022). After multivariable adjustment, only the presence of coagulation disorders at baseline remained independently associated with sHE (adjusted odds ratio, 14.4 [95% CI, 1.04–217];
P
=0.048). sHE was independently associated with poor outcome (King’s Outcome Scale for Childhood Head Injury <5A, odds ratio, 5.77 [95% CI, 1.01–38.95];
P
=0.043).

Conclusions:

sHE is a frequent phenomenon after admission for a pediatric ICH and more so in children with coagulation defects. As sHE was strongly associated with poorer clinical outcomes, these data mandate a baseline coagulation work up and questions the need for protocolized repeat head computed tomography in children admitted for pediatric ICH.
Topics as clusters of citation links to highly cited sources: The
case of research on international relations
Authors: Havemann Frank
Published: January 2021

Following Henry Small in his approach to cocitation analysis, highly cited sources are seen as concept symbols of research fronts. But instead of cocited sources, I cluster citation links, which are the thematically least heterogenous elements in bibliometric studies. To obtain clusters representing topics characterized by concepts, I restrict link clustering to citation links to highly cited sources. Clusters of citation links between papers in a political-science subfield (international relations) and 300 of their sources most cited in the period 2006–2015 are constructed by a local memetic algorithm. It finds local minima in a cost landscape corresponding to clusters, which can overlap each other pervasively. The clusters obtained are well separated from the rest of the network but can have suboptimal cohesion. Cohesive cores of topics are found by applying an algorithm that constructs core-periphery structures in link sets. In this methodological paper I discuss some initial clustering results for the second half of the 10-year period.
Effectiveness of Online Education for the Professional Training of Journalists: Students’ Distance Learning During the COVID-19 Pandemic
Authors: Poluekhtova Irina A. , Vikhrova Olga Yu. , Vartanova Elena L.
Published: January 2021

Background. The necessity to introduce digital technologies in education and in the professional training of journalism students in particular has been widely discussed in the theory and practice of education over the past 20 years. From the point of view of both future research and training, it becomes very important to study the development of journalists’ professional competencies and professional identity in the online environment. Objective. To study the experience of distance learning by students in the faculty of journalism at Lomonosov Moscow State University during the period of restrictive measures in connection with the COVID-19 pandemic (Spring 2020). Design. A two-stage empirical project studied the opinions of students about distance learning, to identify its effectiveness for the formation of professional competencies and identity. In the first stage, a qualitative (investigative) study was conducted on a small sample using semi-formalized tools. In the second stage, a formal survey was conducted on a representative sample (N = 576). Results. We found that in order to achieve the social, educational, and cognitive presence necessary for effective online education, an important condition is the communication environment and stable communication among all participants: students, professors, and academic departments. However, the communicative environment of the traditional training process is not transferred to the online environment in its original form. With Internet technologies, it is difficult to provide a strong teaching presence, which is a catalyst for the development of social and cognitive presence and a key component of traditional professional training. In the online learning mode, students are overloaded with self-study and written assignments, and mastering the necessary professional knowledge, competencies, and skills becomes their own responsibility. Not all components of the traditional educational process (types and forms of classes, educational materials, etc.), remain effective when transferred to the online environment. Conclusion. The formation of professional competencies, as well as the social, cognitive, and behavioral components that determine the further development of professional identity, is difficult in distance education. Online learning cannot be regarded as a full-fledged alternative to the traditional higher professional education of journalists.
!e Psychological Impact of Six Weeks of Lockdown as a Consequence of COVID-19 and the Importance of Social Support: A Cross-Cultural Study Comparing Spanish and Russian Populations
Authors: Ausín Berta , Castellanos Miguel Ángel , González-Sanguino Clara , Vakhantseva Olga V. , Almazova Olga V. , Shaigerova Ludmila A. , Dolgikh Aleksandra G. , Muñoz Manuel
Published: January 2021

Background. !e COVID-19 pandemic has been an unprecedented social and health emergency worldwide. Cross-cultural research on mental health during this situation is needed to better understand its consequences. Objective. To evaluate the di"erent psychological impacts of the crisis and lockdown situation during the #rst six weeks of COVID emergency measures in samples of the Spanish and Russian populations. Design. A cross-sectional study was conducted through an online survey (NSpain = 1041; NRussia = 743). !e prevalence of loneliness, depression, anxiety, perceived discrimination (PD), internalized stigma (IS), and perceived social support (PSS) was evaluated. Chi-square tests and t-tests were administered. The Enter Method were used to identify the predictors of the mental health impact. Results. Di"erences were found between the Russian and the Spanish populations. While the degrees of anxiety and depression did not di"er signi#cantly, loneliness, the alienation dimension of IS, and PD were more pronounced in the Russian respondents. In Spain, the predictor of less negative impact was PSS from various sources, while in Russia we only found PSS from the family. Conclusion. Although in both countries the impact at the clinical level seemed to be similar, di"erences were found at the psychosocial level. Variables with a strong cultural component may be key to determining the means of alleviating the e"ects of the crisis, with PSS being a fundamental protective factor. More crosssectional studies are needed to understand the impact of the pandemic in depth.
Librarians’ development as teachers
Authors: Baer Andrea
Published: January 2021

This article reports on findings of an online survey of teacher librarians about their instructional work, approaches, and roles and how these aspects of their teaching have changed over time. Academic librarians who had at least one year of library teaching experience and who had been actively involved in library instruction within the past two years completed the online survey. Participants were asked a series of questions, the majority of which were open-ended, about the types of instruction-related activities in which they presently and previously engaged, if/how their views of their instructional work and their instructional roles had changed over time, what experiences had been particularly influential in their teaching, and if they identified as teachers. The responses were analyzed through manual textual coding, through which emerging themes and variations in participants’ responses were identified. These findings provide further insight into academic librarians’ ongoing teacher development and their experiences as teaching librarians. Fuller understandings of this development and experiences can inform professional development and communities of practice in which librarians foster a sense of agency, confidence, responsiveness, and purpose in their teaching, cultivate and sustain meaningful teaching practices, and prevent burnout.
Two new species of Macrodactylus (Coleoptera: Scarabaeidae: Melolonthinae: Macrodactylini) from Mexico and Guatemala
Authors: ARCE-PÉREZ ROBERTO , REYNOSO-VELASCO DANIEL
Published: January 2021

Two new species of Macrodactylus Dejean (Coleoptera: Scarabaeidae: Melolonthinae: Macrodactylini) from Mexico and Guatemala are described and illustrated: Macrodactylus miguelangeli new species from Mexico and Guatemala, and M. oaxacaensis new species from Mexico. With the descriptions of these two new species, the total number of species of the genus reaches 124. The characteristics of two closely related species are briefly discussed.
New species of Goja Navás (Psocodea: ‘Psocoptera’: Epipsocidae) from Colombia, Mexico and Peru
Authors: CARREJO NANCY , OBANDO RANULFO GONZÁLEZ , ALDRETE ALFONSO NERI GARCÍA , MENDIVIL JULIÁN
Published: January 2021

Upon examination of epipsocid specimens recently collected in natural areas of Colombia, Mexico and Peru, 17 new species of Goja were found. These are here described and illustrated. An updated key for the identification of males of the described species of Goja is presented.
A Variational Method for Analyzing Vortex Flows in Radar-Scanned Tornadic Mesocyclones. Part II: Tests with Analytically Formulated Vortices
Authors: Xu Qin , Wei Li
Published: January 2021

The variational method formulated in Part I for analyzing vortex flow (VF), called VF-Var, is tested with simulated radar radial-velocity observations from idealized and pseudo-operational Doppler scans of analytically formulated benchmark vortices with spiral-band structures to resemble VFs in observed tornadic mesocyclones. The idealized Doppler scans are unidirectional in parallel along horizontal grid lines of a coarse-resolution grid, so they measure only the horizontal components of three-dimensional velocities in the analysis domain. The pseudo-operational Doppler scans mimic a scan mode used by operational WSR-88Ds for severe storms. Paired numerical experiments are designed and performed to test the two-step analysis versus single-step analysis formulated in VF-Var. Both analyses perform very well with dual-Doppler scans and reasonably well with single-Doppler scans. Errors in the analyzed velocities from single-Doppler scans are mainly in the unobserved velocity components and only in fractions of the benchmark velocities. When the vortex is upright or slanted in the direction perpendicular to idealized single-Doppler scans, the two-step analysis slightly outperforms the single-step analysis for idealized Doppler scans and pseudo-operational dual-Doppler scans. When the vortex becomes slanted in the direction largely along or against Doppler scans, both analyses become less (more) accurate in analyzing the horizontal (slantwise vertical) velocity, and the single-step analysis outperforms the two-step analysis especially for single-Doppler scans. By considering the projections of analyzed velocity on radar beams in the original Cartesian coordinates, useful insights are gained for understanding why and how the analysis accuracies are affected by vortex slanting.
Dual-Polarization Deconvolution and Geophysical Retrievals from the Advanced Microwave Precipitation Radiometer during OLYMPEX/RADEX
Authors: Amiot Corey G. , Biswas Sayak K. , Lang Timothy J. , Duncan David I.
Published: January 2021

Recent upgrades, calibration, and scan-angle bias reductions to the Advanced Microwave Precipitation Radiometer (AMPR) have yielded physically realistic brightness temperatures (Tb) from the Olympic Mountains Experiment and Radar Definition Experiment (OLYMPEX/RADEX) dataset. Measured mixed-polarization Tb were converted to horizontally and vertically polarized Tb via dual-polarization deconvolution, and linear regression equations were developed to retrieve integrated cloud liquid water (CLW), water vapor (WV), and 10-m wind speed (WS) using simulated AMPR Tb and modeled atmospheric profiles. These equations were tested using AMPR Tb collected during four OLYMPEX/RADEX cases; the resulting geophysical values were compared with independent retrieval (1DVAR) results from the same dataset, while WV and WS were also compared with in situ data. Geophysical calculations using simulated Tb yielded relatively low retrieval and crosstalk errors when compared with modeled profiles; average CLW, WV, and WS root-mean-square deviations (RMSD) were 0.11 mm, 1.28 mm, and 1.11 m s−1, respectively, with median absolute deviations (MedAD) of 2.26 × 10−2 mm, 0.22 mm, and 0.55 m s−1, respectively. When applied to OLYMPEX/RADEX data, the new retrieval equations compared well with 1DVAR; CLW, WV, and WS RMSD were 9.95 × 10−2 mm, 2.00 mm, and 2.35 m s−1, respectively, and MedAD were 2.88 × 10−2 mm, 1.14 mm, and 1.82 m s−1, respectively. WV MedAD between the new equations and dropsondes were 2.10 and 1.80 mm at the time and location of minimum dropsonde altitude, respectively, while WS MedAD were 1.15 and 1.53 m s−1, respectively, further indicating the utility of these equations.
A Bimodal Diagnostic Cloud Fraction Parameterization. Part II: Evaluation and Resolution Sensitivity
Authors: Van Weverberg Kwinten , Morcrette Cyril J. , Boutle Ian
Published: January 2021

A wide range of approaches exists to account for subgrid cloud variability in regional simulations of the atmosphere. This paper addresses the following questions: 1) Is there still benefit in representing subgrid variability of cloud in convection-permitting simulations? 2) What is the sensitivity to the cloud fraction parameterization complexity? 3) Are current cloud fraction parameterizations scale-aware across convection-permitting resolutions? These questions are addressed for regional simulations of a 6-week observation campaign in the U.S. southern Great Plains. Particular attention is given to a new diagnostic cloud fraction scheme with a bimodal subgrid saturation-departure PDF, described in Part I. The model evaluation is performed using ground-based remote sensing synergies, satellite-based retrievals, and surface observations. It is shown that not using a cloud fraction parameterization results in underestimated cloud frequency and water content, even for stratocumulus. The use of a cloud fraction parameterization does not guarantee improved cloud property simulations, however. Diagnostic and prognostic cloud schemes with a symmetric subgrid saturation-departure PDF underestimate cloud fraction and cloud optical thickness, and hence overestimate surface shortwave radiation. These schemes require empirical bias-correction techniques to improve the cloud cover. The new cloud fraction parameterization, introduced in Part I, improves cloud cover, liquid water content, cloud-base height, optical thickness, and surface radiation compared to schemes reliant on a symmetric PDF. Furthermore, cloud parameterizations using turbulence-based, rather than prescribed constant subgrid variances, are shown to be more scale-aware across convection-permitting resolutions.
Longitudinal change in restricted and repetitive behaviors from 8-36 months
Authors: Sifre Robin , Berry Daniel , Wolff Jason J. , Elison Jed T.
Published: January 2021

Background

Restricted and repetitive behaviors (RRBs) are core features of autism spectrum disorder (ASD) and one of the earliest behavioral signs of ASD. However, RRBs are also present in typically developing (TD) infants, toddlers, and preschool-aged children. Past work suggests that examining change in these behaviors over time is essential to distinguish between normative manifestations of these behaviors and behaviors that denote risk for a neurodevelopmental disorder. One challenge in examining changes in these behaviors over time is that most measures of RRBs have not established longitudinal measurement invariance. The aims of this study were to (1) establish measurement invariance in the Repetitive Behavior Scales for Early Childhood (RBS-EC), a parent-report questionnaire of RRBs, and (2) model developmental change in RRBs from 8 to 36 months.

Methods

We collected RBS-EC responses from parents of TD infants (n = 180) from 8 to 36 months (n = 606 responses, with participants contributing an average of 3-time points). We leverage a novel methodological approach to measurement invariance testing (Bauer, Psychological Models, 22(3), 507–526, 2017), moderated nonlinear factor analysis (MNLFA), to determine whether the RBS-EC was invariant across age and sex. We then generated adjusted factor score estimates for each subscale of the RBS-EC (repetitive motor, self-directed, and higher-order behaviors), and used linear mixed effects models to estimate between- and within-person changes in the RBS-EC over time.

Results

The RBS-EC showed some non-invariance as a function of age. We were able to adjust for this non-invariance in order to more accurately model changes in the RBS-EC over time. Repetitive motor and self-directed behaviors showed a linear decline from 8 to 36 months, while higher-order behaviors showed a quadratic trajectory such that they began to decline later in development at around 18 months. Using adjusted factor scores as opposed to unadjusted raw mean scores provided a number of benefits, including increased within-person variability and precision.

Conclusions

The RBS-EC is sensitive enough to measure the presence of RRBs in a TD sample, as well as their decline with age. Using factor score estimates of each subscale adjusted for non-invariance allowed us to more precisely estimate change in these behaviors over time.
Maternal folic acid impacts DNA methylation profile in male rat offspring implicated in neurodevelopment and learning/memory abilities
Authors: Wang Xinyan , Li Zhenshu , Zhu Yun , Yan Jing , Liu Huan , Huang Guowei , Li Wen
Published: January 2021

Background

Periconceptional folic acid (FA) supplementation not only reduces the incidence of neural tube defects, but also improves cognitive performances in offspring. However, the genes or pathways that are epigenetically regulated by FA in neurodevelopment were rarely reported.

Methods

To elucidate the underlying mechanism, the effect of FA on the methylation profiles in brain tissue of male rat offspring was assessed by methylated DNA immunoprecipitation chip. Differentially methylated genes (DMGs) and gene network analysis were identified using DAVID and KEGG pathway analysis.

Results

Compared with the folate-normal diet group, 1939 DMGs were identified in the folate-deficient diet group, and 1498 DMGs were identified in the folate-supplemented diet group, among which 298 DMGs were overlapped. The pathways associated with neurodevelopment and learning/memory abilities were differentially methylated in response to maternal FA intake during pregnancy, and there were some identical and distinctive potential mechanisms under FA deficiency or FA-supplemented conditions.

Conclusions

In conclusion, genes and pathways associated with neurodevelopment and learning/memory abilities were differentially methylated in male rat offspring in response to maternal FA deficiency or supplementation during pregnancy.
Sensitivity enriched multi-criterion decision making process for novel railway switches and crossings − a case study
Authors: Boghani Hitesh C. , Ambur Ramakrishnan , Blumenfeld Marcelo , Saade Louis , Goodall Roger M. , Ward Christopher P. , Plášek Otto , Gofton Neil , Morata Miquel , Roberts Clive , Dixon Roger
Published: January 2021

Background

Despite their important role in railway operations, switches and crossings (S&C) have changed little since their conception over a century ago. It stands now that the existing designs for S&C are reaching their maximum point of incremental performance improvement, and only a radical redesign can overcome the constraints that current designs are imposing on railway network capacity. This paper describes the process of producing novel designs for next generation switches and crossings, as part of the S-CODE project.

Methods

Given the many aspects that govern a successful S&C design, it is critical to adopt multi criteria decision making (MCDM) processes to identify a specific solution for the next generation of switches and crossings. However, a common shortcoming of these methods is that their results can be heavily influenced by external factors, such as uncertainty in criterium weighting or bias of the evaluators, for example. This paper therefore proposes a process based on the Pugh Matrix method to reduce such biases by using sensitivity analysis to investigate them and improve the reliability of decision making.

Results

In this paper, we analysed the influences of three different external factors, measuring the sensitivity of ranking due to (a) weightings, (b) organisational and (c) discipline bias. The order of preference of the results was disturbed only to a minimum while small influences of bias were detected.

Conclusions

Through this case study, we believe that the paper demonstrates an effective case study for a quantitative process that can improve the reliability of decision making.
NanoSIMS observations of mouse retinal cells reveal strict metabolic controls on nitrogen turnover
Authors: Bonnin Elisa A. , Fornasiero Eugenio F. , Lange Felix , Turck Christoph W. , Rizzoli Silvio O.
Published: January 2021

Background

Most of the cells of the mammalian retina are terminally differentiated, and do not regenerate once fully developed. This implies that these cells have strict controls over their metabolic processes, including protein turnover. We report the use of metabolic labelling procedures and secondary ion mass spectrometry imaging to examine nitrogen turnover in retinal cells, with a focus on the outer nuclear layer, inner nuclear layer, and outer plexiform layer.

Results

We find that turnover can be observed in all cells imaged using NanoSIMS. However, the rate of turnover is not constant, but varies between different cellular types and cell regions. In the inner and outer nuclear layers, turnover rate is higher in the cytosol than in the nucleus of each cell. Turnover rates are also higher in the outer plexiform layer. An examination of retinal cells from mice that were isotopically labeled very early in embryonic development shows that proteins produced during this period can be found in all cells and cell regions up to 2 months after birth, even in regions of high turnover.

Conclusions

Our results indicate that turnover in retinal cells is a highly regulated process, with strict metabolic controls. We also observe that turnover is several-fold higher in the synaptic layer than in cell layers. Nevertheless, embryonic proteins can still be found in this layer 2 months after birth, suggesting that stable structures persist within the synapses, which remain to be determined.
Complementary transcriptomic and proteomic analyses reveal the cellular and molecular processes that drive growth and development of Fasciola hepatica in the host liver
Authors: Cwiklinski Krystyna , Robinson Mark W. , Donnelly Sheila , Dalton John P.
Published: January 2021

Background

The major pathogenesis associated withFasciola hepaticainfection results from the extensive tissue damage caused by the tunnelling and feeding activity of immature flukes during their migration, growth and development in the liver. This is compounded by the pathology caused by host innate and adaptive immune responses that struggle to simultaneously counter infection and repair tissue damage.

Results

Complementary transcriptomic and proteomic approaches defined theF. hepaticafactors associated with their migration in the liver, and the resulting immune-pathogenesis. Immature liver-stage flukes express ~ 8000 transcripts that are enriched for transcription and translation processes reflective of intensive protein production and signal transduction pathways. Key pathways that regulate neoblast/pluripotent cells, including the PI3K-Akt signalling pathway, are particularly dominant and emphasise the importance of neoblast-like cells for the parasite’s rapid development. The liver-stage parasites display different secretome profiles, reflecting their distinct niche within the host, and supports the view that cathepsin peptidases, cathepsin peptidase inhibitors, saposins and leucine aminopeptidases play a central role in the parasite’s destructive migration, and digestion of host tissue and blood. Immature flukes are also primed for countering immune attack by secreting immunomodulating fatty acid binding proteins (FABP) and helminth defence molecules (FhHDM). Combined with published host microarray data, our results suggest that considerable immune cell infiltration and subsequent fibrosis of the liver tissue exacerbates oxidative stress within parenchyma that compels the expression of a range of antioxidant molecules within both host and parasite.

Conclusions

The migration of immatureF. hepaticaparasites within the liver is associated with an increase in protein production, expression of signalling pathways and neoblast proliferation that drive their rapid growth and development. The secretion of a defined set of molecules, particularly cathepsin L peptidases, peptidase-inhibitors, saponins, immune-regulators and antioxidants allow the parasite to negotiate the liver micro-environment, immune attack and increasing levels of oxidative stress. This data contributes to the growingF. hepatica-omics information that can be exploited to understand parasite development more fully and for the design of novel control strategies to prevent host liver tissue destruction and pathology.
Genome-wide identification of the histone acetyltransferase gene family in Triticum aestivum
Authors: Gao Shiqi , Li Linzhi , Han Xiaolei , Liu Tingting , Jin Peng , Cai Linna , Xu Miaoze , Zhang Tianye , Zhang Fan , Chen Jianping , Yang Jian , Zhong Kaili
Published: January 2021

Background

Histone acetylation is a ubiquitous and reversible post-translational modification in eukaryotes and prokaryotes that is co-regulated by histone acetyltransferase (HAT) and histone deacetylase (HDAC). HAT activity is important for the modification of chromatin structure in eukaryotic cells, affecting gene transcription and thereby playing a crucial regulatory role in plant development. Comprehensive analyses of HAT genes have been performed in Arabidopsis thaliana, Oryza sativa, barley, grapes, tomato, litchi and Zea mays, but comparable identification and analyses have not been conducted in wheat (Triticum aestivum).

Results

In this study, 31 TaHATs were identified and divided into six groups with conserved gene structures and motif compositions. Phylogenetic analysis was performed to predict functional similarities between Arabidopsis thaliana, Oryza sativa and Triticum aestivum HAT genes. The TaHATs appeared to be regulated by cis-acting elements such as LTR and TC-rich repeats. The qRT–PCR analysis showed that the TaHATs were differentially expressed in multiple tissues. The TaHATs in expression also responded to temperature changes, and were all significantly upregulated after being infected by barley streak mosaic virus (BSMV), Chinese wheat mosaic virus (CWMV) and wheat yellow mosaic virus (WYMV).

Conclusions

These results suggest that TaHATs may have specific roles in the response to viral infection and provide a basis for further study of TaHAT functions in T. aestivum plant immunity.
Berberine alters gut microbial function through modulation of bile acids
Authors: Wolf Patricia G. , Devendran Saravanan , Doden Heidi L. , Ly Lindsey K. , Moore Tyler , Takei Hajime , Nittono Hiroshi , Murai Tsuyoshi , Kurosawa Takao , Chlipala George E. , Green Stefan J. , Kakiyama Genta , Kashyap Purna , McCracken Vance J. , Gaskins H. Rex , Gillevet Patrick M. , Ridlon Jason M.
Published: January 2021

Background

Berberine (BBR) is a plant-based nutraceutical that has been used for millennia to treat diarrheal infections and in contemporary medicine to improve patient lipid profiles. Reduction in lipids, particularly cholesterol, is achieved partly through up-regulation of bile acid synthesis and excretion into the gastrointestinal tract (GI). The efficacy of BBR is also thought to be dependent on structural and functional alterations of the gut microbiome. However, knowledge of the effects of BBR on gut microbiome communities is currently lacking. Distinguishing indirect effects of BBR on bacteria through altered bile acid profiles is particularly important in understanding how dietary nutraceuticals alter the microbiome.

Results

Germfree mice were colonized with a defined minimal gut bacterial consortium capable of functional bile acid metabolism (Bacteroides vulgatus, Bacteroides uniformis, Parabacteroides distasonis, Bilophila wadsworthia, Clostridium hylemonae, Clostridium hiranonis, Blautia producta; B4PC2). Multi-omics (bile acid metabolomics, 16S rDNA sequencing, cecal metatranscriptomics) were performed in order to provide a simple in vivo model from which to identify network-based correlations between bile acids and bacterial transcripts in the presence and absence of dietary BBR. Significant alterations in network topology and connectivity in function were observed, despite similarity in gut microbial alpha diversity (P = 0.30) and beta-diversity (P = 0.123) between control and BBR treatment. BBR increased cecal bile acid concentrations, (P < 0.05), most notably deoxycholic acid (DCA) (P < 0.001). Overall, analysis of transcriptomes and correlation networks indicates both bacterial species-specific responses to BBR, as well as functional commonalities among species, such as up-regulation of Na+/H+ antiporter, cell wall synthesis/repair, carbohydrate metabolism and amino acid metabolism. Bile acid concentrations in the GI tract increased significantly during BBR treatment and developed extensive correlation networks with expressed genes in the B4PC2 community.

Conclusions

This work has important implications for interpreting the effects of BBR on structure and function of the complex gut microbiome, which may lead to targeted pharmaceutical interventions aimed to achieve the positive physiological effects previously observed with BBR supplementation.
Relaxing the assumption of constant transition rates in a multi-state model in hospital epidemiology
Authors: Hill Micki , Lambert Paul C. , Crowther Michael J.
Published: January 2021

Background

Multi-state models are being increasingly used to capture complex disease pathways. The convenient formula of the exponential multi-state model can facilitate a quick and accessible understanding of the data. However, assuming time constant transition rates is not always plausible. On the other hand, obtaining predictions from a fitted model with time-dependent transitions can be challenging. One proposed solution is to utilise a general simulation algorithm to calculate predictions from a fitted multi-state model.

Methods

Predictions obtained from an exponential multi-state model were compared to those obtained from two different parametric models and to non-parametric Aalen-Johansen estimates. The first comparative approach fitted a multi-state model with transition-specific distributions, chosen separately based on the Akaike Information Criterion. The second approach was a Royston-Parmar multi-state model with 4 degrees of freedom, which was chosen as a reference model flexible enough to capture complex hazard shapes. All quantities were obtained analytically for the exponential and Aalen-Johansen approaches. The transition rates for the two comparative approaches were also obtained analytically, while all other quantities were obtained from the fitted models via a general simulation algorithm. Metrics investigated were: transition probabilities, attributable mortality (AM), population attributable fraction (PAF) and expected length of stay. This work was performed on previously analysed hospital acquired infection (HAI) data. By definition, a HAI takes three days to develop and therefore selected metrics were also predicted from time 3 (delayed entry).

Results

Despite clear deviations from the constant transition rates assumption, the empirical estimates of the transition probabilities were approximated reasonably well by the exponential model. However, functions of the transition probabilities, e.g. AM and PAF, were not well approximated and the comparative models offered considerable improvements for these metrics. They also provided consistent predictions with the empirical estimates in the case of delayed entry time, unlike the exponential model.

Conclusion

We conclude that methods and software are readily available for obtaining predictions from multi-state models that do not assume constant transition rates. The package in facilitates a range of predictions with confidence intervals, which can provide a more comprehensive understanding of the data. User-friendly code is provided.
Flexible modelling of risk factors on the incidence of pneumonia in young children in South Africa using piece-wise exponential additive mixed modelling
Authors: Ramjith Jordache , Roes Kit C.B. , Zar Heather J. , Jonker Marianne A.
Published: January 2021

Introduction

Recurrent episodes of pneumonia are frequently modeled using extensions of the Cox proportional hazards model with the underlying assumption of time-constant relative risks measured by the hazard ratio. We aim to relax this assumption in a study on the effect of factors on the evolution of pneumonia incidence over time based on data from a South African birth cohort study, the Drakenstein child health study.

Methods

We describe and apply two models: a time-constant and a time-varying relative effects model in a piece-wise exponential additive mixed model’s framework for recurrent events. A more complex model that fits in the same framework is applied to study the continuously measured seasonal effects.

Results

We find that several risk factors (male sex, preterm birth, low birthweight, lower socioeconomic status, lower maternal education and maternal cigarette smoking) have strong relative effects that are persistent across time. When time-varying effects are allowed in the model, HIV exposure status (HIV exposed & uninfected versus HIV unexposed) shows a strong relative effect for younger children, but this effect weakens as children grow older, with a null effect reached from about 15 months. Weight-for-length at birth shows a time increasing relative effect. We also find that children born in the summer have a much higher risk of pneumonia in the 3-to-8-month age period compared with children born in winter.

Conclusion

This work highlights the usefulness of flexible modelling tools in recurrent events models. It avoids stringent assumptions and allows estimation and visualization of absolute and relative risks over time of key factors associated with incidence of pneumonia in young children, providing new perspectives on the role of risk factors such HIV exposure.
General practitioner trainees’ career perspectives after COVID-19: a qualitative study in China
Authors: Yin Yue , Chu Xiaotian , Han Xinxin , Cao Yu , Di Hong , Zhang Yun , Zeng Xuejun
Published: January 2021

Background

The coronavirus disease 2019 (COVID-19) has been a worldwide public health emergency that has put great pressure on medical workers and the medical system. General Practitioners (GPs) played an important role in controlling the epidemic, and GP trainees also took an active part in this approach. This study was to explore Chinese GP trainees’ career perspectives after COVID-19.

Methods

We conducted a qualitative research study which included 12 GP trainees from three teaching hospitals in China. Semi-structured telephone interviews were conducted. Grounded theory and thematic analysis were used to code the data and identify categories and factors.

Results

Eleven participants chose to continue a GP career after COVID-19, and nearly half of the participants strengthened their determination to dedicate themselves to this career. Only one participant decided to change the career choice because of interest in another specialty. Four main themes influencing GP trainees’ perceptions of career development after COVID-19 emerged from the interviews: changes of GPs’ work content in COVID-19, challenges of being a GP, psychological changes of the career, how to provide better primary care. Although some negative psychological changes existed, most of participants were inspired by role models and medical colleagues. They had more in-depth understanding of GPs’ role and responsibility during COVID-19, and exhibited intensions for self-improvement in career development, especially in public health education and self-protection in preventing infectious diseases. In addition, the wide use of telemedicine provided a new work way for GP trainees. However, challenges, such as increased workloads, low income, lack of resources in primary medical institutions, and distrust of GPs are faced by trainees during the outbreak.

Conclusions

Overall, no substantial changes were seen in the career choice of GP trainees after COVID-19 outbreak. However, they were inspired and had an in-depth understanding about the GP’s work and responsibility during an epidemic. Owing to the challenges faced by the GPs, measures are needed to improve the GP education and work environment in the training phase.
JAK-inhibitor and type I interferon ability to produce favorable clinical outcomes in COVID-19 patients: a systematic review and meta-analysis
Authors: Walz Lucas , Cohen Avi J. , Rebaza Andre P. , Vanchieri James , Slade Martin D. , Dela Cruz Charles S. , Sharma Lokesh
Published: January 2021

Background

The spread of a highly pathogenic, novel coronavirus (SARS-CoV-2) has emerged as a once-in-a-century pandemic, having already infected over 63 million people worldwide. Novel therapies are urgently needed. Janus kinase-inhibitors and Type I interferons have emerged as potential antiviral candidates for COVID-19 patients due to their proven efficacy against diseases with excessive cytokine release and their direct antiviral ability against viruses including coronaviruses, respectively.

Methods

A search of MEDLINE and MedRxiv was conducted by three investigators from inception until July 30th 2020 and included any study type that compared treatment outcomes of humans treated with Janus kinase-inhibitor or Type I interferon against controls. Inclusion necessitated data with clearly indicated risk estimates or those that permitted their back-calculation. Outcomes were synthesized using RevMan.

Results

Of 733 searched studies, we included four randomized and eleven non-randomized trials. Five of the studies were unpublished. Those who received Janus kinase-inhibitor had significantly reduced odds of mortality (OR, 0.12; 95% CI, 0.03–0.39, p< 0.001) and ICU admission (OR, 0.05; 95% CI, 0.01–0.26, p< 0.001), and had significantly increased odds of hospital discharge (OR, 22.76; 95% CI, 10.68–48.54, p< 0.00001) when compared to standard treatment group. Type I interferon recipients had significantly reduced odds of mortality (OR, 0.19; 95% CI, 0.04–0.85, p< 0.05), and increased odds of discharge bordering significance (OR, 1.89; 95% CI, 1.00–3.59, p=0.05).

Conclusions

Janus kinase-inhibitor treatment is significantly associated with positive clinical outcomes in terms of mortality, ICU admission, and discharge. Type I interferon treatment is associated with positive clinical outcomes in regard to mortality and discharge. While these data show promise, additional well-conducted RCTs are needed to further elucidate the relationship between clinical outcomes and Janus kinase-inhibitors and Type I interferons in COVID-19 patients.
HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis
Authors: Sultana Zeeba Zahra , Hoque Farhana Ul , Beyene Joseph , Akhlak-Ul-Islam Md. , Khan Md Hasinur Rahman , Ahmed Shakil , Hawlader Delwer Hossain , Hossain Ahmed
Published: January 2021

Background

Multidrug-resistant tuberculosis (MDR-TB) in HIV infected individuals is a serious threat to global efforts to combat tuberculosis. Inconsistent findings on the association between HIV infection and MDR-TB were present in many studies. We aimed to review existing data on the relationship between HIV infection and MDR-TB systematically to assess the contribution of HIV on MDR-TB worldwide. We also investigated the patterns of MDR-TB by age, country-wise income, study designs, and global regions.

Methods

We utilized PubMed, Google Scholar, and ScienceDirect databases to select eligible studies for meta-analysis that were published between January 1, 2010, and July 30, 2020. The random-effects model was used to obtain the pooled odds ratio of the crude association between HIV and MDR-TB with a 95% confidence interval. We investigated the potential publication-bias by checking funnel plot asymmetry and using the Egger’s test. Moreover, we assessed the heterogeneity using the I2 statistic. Sensitivity analysis was performed based on sample size and adjustment factors. The protocol was registered with PROSPERO-CRD42019132752.

Results

We identified 1603 studies through a database search, and after subsequent eliminations we selected 54 studies including 430,534 TB patients. The pooled odds of MDR-TB was 1.42 times higher in HIV-positive patients than HIV-negative patients (OR=1.42,CI=1.17–1.71, I2=75.8%). Subgroup analysis revealed that the estimated pooled odds for South-East Asian countries was 1.86, which is the highest in WHO regions (OR=1.86,CI=1.30–2.67, I2=0.00%), followed by Europe and Africa. The effect estimate was found to be higher for primary MDR-TB (OR=2.76,CI=1.70–4.46, I2=0.00%). There was also a trend towards increased odds of MDR-TB for HIV patients older than 40 years (OR=1.56,CI=1.17–2.06). The association was found to be significant in high-burden TB countries (OR=1.75, CI=1.39–2.19) and in high-income countries (OR=1.55, CI=1.06–2.27).

Conclusion

Such findings indicate that HIV infection raises the risk of MDR-TB, and after contrasting it with the results of the earlier pooled study, it appeared to be an upward risk trend. Moreover, we found that the risk is the highest in the South-East Asian region. A balanced allocation of resources is needed to halt both primary and secondary MDR-TB, particularly in HIV infected people with 40 years of age and older.
Balanced steady-state free precession MRCP is a robust alternative to respiration-navigated 3D turbo-spin-echo MRCP
Authors: Hasse Felix Christian , Selmi Buket , Albusaidi Hamed , Mokry Theresa , Mayer Philipp , Rupp Christian , Kauczor Hans-Ulrich , Weber Tim Frederik
Published: January 2021

Background

Despite synchronization to respiration, respiration-navigated (RN) 3D turbo-spin-echo MRCP is limited by susceptibility to motion artifacts. The aim of this study was to assess the quality of pancreaticobiliary duct visualization of a non-RN MRCP alternative based on balanced steady-state free precession imaging (BSSFP) with overlapping slices compared with RN-MRCP.

Methods

This is a retrospective study on 50 patients without pancreaticobiliary duct disease receiving MRCP at 1.5 T. We performed an intraindividual comparison of coronal RN-MRCP with combined coronal and transverse BSSFP-MRCP. Image quality was scored by 3 readers for 6 pancreaticobiliary duct segments (3 pancreatic, 3 biliary) using a 6-point scale. A segment score of 3 or lower as assessed by at least 2 of 3 readers was defined as insufficient segment visualization. Nonparametric tests and interrater reliability testing were used for statistical analysis.

Results

Overall duct visualization averaged over all readers was scored with 4.5 ± 1.1 for RN-MRCP (pancreatic, 4.1 ± 0.5; biliary, 5.0 ± 0.4) and 4.9 ± 0.9 for combined coronal and transverse BSSFP-MRCP (pancreatic, 4.6 ± 0.6; biliary, 5.1 ± 0.6), respectively (p < 0.001). The number of segments visualized insufficiently was 81/300 for RN-MRCP and 43/300 for BSSFP-MRCP (p < 0.001). Segments visualized insufficiently only in RN-MRCP had a mean score of 4.4 ± 0.8 in BSSFP-MRCP. Overall interrater agreement on superiority of BSSFP-MRCP segment scores over corresponding RN-MRCP was 0.70. Mean acquisition time was 98% longer for RN-MRCP (198.0 ± 98.7 s) than for combined coronal and transverse BSSFP-MRCP (100.2 ± 0.4 s).

Conclusions

Non-RN BSSFP-MRCP with overlapping slices is a fast alternative to RN-MRCP, frequently providing sufficient duct visualization when RN-MRCP fails.
A retrospective study of end-stage kidney disease patients on maintenance hemodialysis with renal osteodystrophy-associated fragility fractures
Authors: Xie Lihua , Hu Xuantao , Li Wenzhao , Ouyang Zhengxiao
Published: January 2021

Background

Nephropathy associated metabolic disorder induces high incidence of fragility fracture in end-stage renal disease (ESRD) patients. As the risk factors and prognosis of fragility fracture in ESRD patients are unclear, more research is needed. This study aimed to evaluate various risk factors for ESRD-related fragility fractures, explore factors affecting the prognosis of patients with such fractures, and provide information for prevention and treatment of renal osteopathy to improve the prognosis of patients.

Methods

In this retrospective case-control study, the case notes of 521 ESRD patients who received maintenance dialysis for at least 3 months were examined. Finally, 44 patients diagnosed with fragility fractures were assigned to the fragility fracture (FF) group and 192 patients were included in the control group (CG). Demographic information, underlying diseases, nutritional, bone metabolism, and renal function parameters, along with the number and causes of any deaths, were recorded for multiple statistical analysis.

Results

The FF group had increased incidences of essential hypertension and diabetes mellitus and higher serum calcium, corrected calcium, alkaline phosphatase, and hemoglobin levels. Immunoreactive parathyroid hormone (iPTH), total cholesterol (TC), and low density lipoprotein (LDL) levels were higher in the CG. Multivariate Cox regression analysis revealed that fragility fracture was an independent risk factor for all-cause mortality in ESRD patients (P < .001, RR: 4.877, 95% CI: 2.367–10.013).

Conclusions

Essential hypertension and diabetes, high serum calcium and alkaline phosphatase levels, and reduced iPTH levels were risk factors for fragility fracture in ESRD patients. Maintaining iPTH and serum TC levels may protect against fragility fractures in them. Fragility fractures may yield poor prognosis and shorter lifespan. The presence of fragility fracture was an independent predictor of all-cause death in ESRD patients.