bluuebunny/crossref_metadata_2025 huggingface dataset:
Collective Security or Colonial Revolution? The 1938 Conference on Peace and Empire, Anticolonialism, and the Popular Front
Authors: Williams Theo
Published: March 2020

The 1938 Conference on Peace and Empire was emblematic of the deep divisions within the British socialist movement over the inseparable issues of fascism, war, capitalism, and colonialism. One grouping, around the Communist Party, the Labour Left, and the India League, espoused a reformist anticolonialism tied to a Popular Front of socialists and liberals and the collective security of the democratic powers against the menace of fascism. Another grouping, around the Independent Labour Party (ILP) and the International African Service Bureau (IASB), believed distinctions between ‘democratic’ and fascist colonialism to be flawed and instead advocated anticolonial revolution while rejecting what they saw as pleas to support colonialist policies under the guise of antifascism. This article advances three overlapping arguments. First, that the Popular Front strategy led Communists to promote antifascist alliances that necessarily diminished their anticolonialist activism. Secondly, that the IASB-ILP coalition was the most consistently militant anticolonialist force in Britain during the second half of the 1930s. Thirdly, that we need to more thoroughly integrate both the history of anticolonialism and the ideas and activism of people of colour into our understandings of inter-war British socialism.
Complete Genome Sequence of Bacillus sp. strain WR11, an Endophyte Isolated from Wheat Root Providing Genomic Insights into Its Plant Growth-Promoting Effects
Authors: Chen Can , Yue Zonghao , Chu Cuiwei , Ma Keshi , Li Lili , Sun Zhongke
Published: March 2020

Bacillus sp. strain WR11 isolated from the root of wheat (Triticum aestivum L.) possesses abiotic stress alleviating properties and produces several types of enzymes. However, its genomic information is lacking. The study described the complete genome sequence of the bacterium. The size of the genome was 4 202 080 base pairs that consisted of 4 405 genes in total. The G+C content of the circular genome was 43.53% and there were 4 170 coding genes, 114 pseudo genes, 30 ribosome RNAs, 86 tRNAs, and 5 ncRNAs, based on the Prokaryotic Genome Annotation Pipeline (PGAP). Many genes were related to the stress-alleviating properties and 124 genes existed in the CAZy database. The complete genome data of strain WR11 will provide valuable resources for genetic dissection of its plant growth-promoting function and symbiotic interaction with plant.
Population Structure of Fusarium graminearum Isolated from Different Sources in One Area over the Course of Three Years
Authors: Sneideris Donatas , Ivanauskas Algirdas , Prakas Petras , Butkauskas Dalius , Treikale Olga , Kadziene Grazina , Rasiukeviciute Neringa , Kelpsiene Jurgita , Suproniene Skaidre
Published: March 2020

Fusarium head blight (FHB) is an important crop disease worldwide and is mainly caused by members of the Fusarium graminearum species complex. F. graminearum sensu stricto is the most common cosmopolitan and predominant FHB causal agent in Europe. Thus far, the majority of studies have focused on the primary hosts (wheat and barley) of this pathogen, while the relationships between other sources of infection remain unclear. We monitored and sampled test fields over the course of 3 years and acquired 804 F. graminearum isolates from different sources: primary hosts and other plant species included in the crop rotations, weeds from the test fields, decaying plant residue, soil samples, and crop seed. Of these isolates, 73.3% had the 15-acetyldeoxynivalenol genotype and 26.7% had the 3-acetyldeoxynivalenol genotype. F. graminearum isolation rates from weeds (>50%) were much higher than from soil (< 10%) or decaying plant matter (4%). Variable number of tandem repeat markers were used for population analysis. Noticeable genetic differentiation was detected between isolates from living plants and soil biome. In contrast, absence of any noticeable division between primary and alternative plant host communities indicates the importance of weeds and other segetal plants for FHB control and prevention.
Spatiotemporal Spread of Abnormal Vertical Growth of Macadamia in Australia Informs Epidemiology
Authors: Zakeel Mohamed C. M. , Geering Andrew D. W. , Akinsanmi Olufemi A.
Published: March 2020

Australian macadamia production is threatened by a disorder known as abnormal vertical growth (AVG), for which the etiology is unknown. AVG is characterized by vigorous upright growth and reduced lateral branching, flowering, and nut set that results in over 70% yield loss annually. Six commercial macadamia orchards were surveyed in 2012 and again in 2018 to examine spatiotemporal dynamics of the epidemic. Data were subjected to point-pattern and geostatistical analyses. AVG incidence in all orchards showed a better fit to the beta-binomial distribution than the binomial distribution. AVG incidence in the different orchards varied between 5 and 47% in 2012, and 13 and 55% in 2018 and the rate of spread was slow, averaging at about 2% increase in disease incidence per annum. Spatial patterns of AVG were highly aggregated on both survey years and spread was mainly between neighboring trees in a row or trees that were opposite to each other in different rows. Semivariograms showed large range values (approximately 15 to 120), indicating aggregation of AVG-affected trees beyond quadrat levels. Furthermore, clusters of disease were mainly at the edge of the orchard on the first survey date and the disease progressed toward the center of the orchard over time. It is concluded that AVG is caused by an infectious agent, and based on patterns of spread, we hypothesize that spread is facilitated by root grafting or root-to-root contact. Furthermore, a vascular-limited pathogen could be involved that modulates plant hormone production.
The association between neighborhood greenness and incidence of lethal prostate cancer
Authors: Iyer Hari S. , James Peter , Valeri Linda , Hart Jaime E. , Pernar Claire H. , Mucci Lorelei A. , Holmes Michelle D. , Laden Francine , Rebbeck Timothy R.
Published: March 2020

Background:

Growing evidence suggests that neighborhood contextual environment could influence risk factors and, therefore, incidence of lethal prostate cancer. We studied the association between neighborhood greenness and lethal prostate cancer incidence and assessed mediation by vigorous physical activity.

Methods:

A total of 47,958 participants were followed in the Health Professionals Follow-up Study from 1986 to 2014. Neighborhood greenness exposure was estimated using normalized difference vegetation index (NDVI) with 1 km resolution, assigned to home or work addresses at start of follow-up. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using sequentially adjusted Cox models with individual and contextual prostate cancer risk factors as covariates. Analyses were compared among those whose addresses were constant over follow-up and stratified by population density and address type.

Results:

We observed 898 cases over 1,054,743 person-years. An interquartile range increase in NDVI was associated with 5% lower rate of lethal prostate cancer (aHR = 0.95, 95% CI = 0.88, 1.03), with stronger associations in nonmovers (aHR = 0.92, 95% CI = 0.85, 1.01). Inverse associations were observed among men in high (aHR = 0.90, 95% CI = 0.82, 0.99) but not low (aHR = 1.11, 95% CI = 0.95, 1.29, P
het = 0.086) population density areas, and those reporting from work (aHR = 0.87, 95% CI = 0.75, 1.01) but not home (aHR = 1.04, 95% CI = 0.91, 1.17, P
het = 0.10) addresses. There was no evidence of mediation by vigorous physical activity.

Conclusion:

We report inverse associations between neighborhood greenness and lethal prostate cancer when restricting to nonmovers and in high population density areas. Replication could confirm findings and clarify mechanisms.
A Unique Presentation of Levamisole-Induced Antineutrophil- Cytoplasmic-Antibody-Positive Vasculitis Presenting as Inflammatory Orbitopathy
Authors: Muniz Castro Hannah M. , Do Thai H. , Bhattacharjee Meenakshi B. , Adesina Ore-ofe O. , Richani Karina
Published: March 2020

A 35-year-old woman with a history of cocaine abuse presented with progressively worsening OS pain. Neuroimaging revealed a 3-cm ill-defined left orbital lesion involving the intraconal and extraconal spaces. The orbital mass was biopsied via an anterior orbitotomy approach. Pathology demonstrated prominent angiocentric granulomatous and lymphoplasmacytic inflammation consistent with vasculitis. Laboratory tests were significant for neutropenia, positive perinuclear antineutrophil cytoplasmic antibodies with high titer, and positive myeloperoxidase antibodies, consistent with levamisole-induced vasculitis. To the authors’ knowledge, this is the first reported case of cocaine–levamisole-induced vasculitis presenting as orbitopathy.
Caregiver Strain and Heart Failure Patient Clinical Event Risk
Authors: Bidwell Julie T. , Lee Christopher S. , Higgins Melinda K. , Reilly Carolyn M. , Clark Patricia C. , Dunbar Sandra B.
Published: March 2020

Background

In a study of Italian heart failure patient-caregiver dyads, greater caregiver strain significantly predicted lower patient clinical event risk.

Objective

The purpose of this secondary analysis was to examine this relationship in a sample from the United States.

Methods

Data came from 92 dyads who participated in a self-care intervention. Logistic regression was used to test the relationship between baseline strain (Bakas Caregiving Outcomes Scale, divided into tertiles) and patient likelihood of events (heart failure hospitalization/emergency visit or all-cause mortality) over 8 months.

Results

Nearly half of patients (n = 40, 43.5%) had an event. High (vs low) caregiver strain was associated with a 92.7% event-risk reduction, but with substantial variability around the effect (odds ratio, 0.07; 95% confidence interval, 0.01–0.63; P = .02).

Conclusions

Although findings were similar to the Italian study, the high degree of variability and contrasting findings to other studies signal a level of complexity that warrants further investigation.
Decreasing Heart Failure Readmissions Among Older Patients With Cognitive Impairment by Engaging Caregivers
Authors: Agarwal Kathryn S. , Bhimaraj Arvind , Xu Jiaqiong , Bionat Susan , Pudlo Michael , Miranda David , Campbell Claire , Taffet George E.
Published: March 2020

Background

Cognitive impairment is common in older patients with heart failure (HF), leading to higher 30-day readmission rates than those without cognitive impairment.

Objectives

The aim of this study was to determine whether increased readmissions in older adults with cognitive impairment are related to HF severity and whether readmissions can be modified by caregiver inclusion in nursing discharge education.

Methods

This study used prospective quality improvement program of cognitive testing and inclusion of caregivers in discharge education with chart review. Two hundred thirty-two patients older than 70 years admitted with HF were screened for cognitive impairment using the Mini-Cog; if score was less than 4, nurses were asked to include caregivers in education on 2 cardiovascular units with an enhanced discharge program. Individuals with ventricular assist device, transplant, or hospice were excluded. Measurements include Mini-Cog score, 30-day readmissions, readmission risk score, ejection fraction, brain natriuretic peptide, and medical comorbidities.

Results

Readmission Risk Scores for HF did not correlate with Mini-Cog scores, but admission brain natriuretic peptide levels were less abnormal in those with better Mini-Cog scores. Only for patients with cognitive impairment, involving caregivers in discharge teaching given by registered and advanced practice nurses was associated with decreased 30-day readmissions from 35% to 16% (P = .01). Readmission rates without/with cognitive impairment were 14.1% and 23.8%, respectively (P = .09). Abnormal Mini-Cog screen was associated with a significantly increased risk of 30-day readmission (odds ratio, 2.23; 95% confidence interval, 1.06–4.68; P = .03), whereas nurse documentation of education with family was associated with a significantly decreased risk of 30-day readmission (odds ratio, 0.46; 95% confidence interval, 0.24–0.90; P = .02).

Conclusions

Involving caregivers in discharge education significantly reduced 30-day readmission rates for patients with HF and cognitive impairment. The Readmission Risk Score was similar between patients older than 70 years with and without cognitive impairment. We have hypothesis-generating evidence that identification of cognitive impairment and targeted caregiver engagement by nurses may be critical in the reduction of readmission rates for older patients with HF.
Increased Rate of Pump Thrombosis and Cardioembolic Events Following Ventricular Tachycardia Ablation in Patients Supported With Left Ventricular Assist Devices
Authors: Grinstein Jonathan , Garan A. Reshad , Oesterle Adam , Fried Justin , Imamura Teruhiko , Mai Xingchen , Kalantari Sara , Sayer Gabriel , Kim Gene H. , Sarswat Nitasha , Raikhelkar Jayant , Adatya Sirtaz , Jeevanandam Valluvan , Flatley Erin , Moss Joshua , Uriel Nir
Published: March 2020

Ventricular arrhythmias are common following left ventricular assist device implantation (LVAD), and the effects of ventricular tachycardia (VT) ablation on thrombosis and embolic events are unknown. We aimed to assess LVAD thrombosis, stroke, and embolic event rates after VT ablation. Left ventricular assist device implantation patients from two academic centers who underwent endocardial VT ablation between 2009 and 2016 were compared to a control group with VT who were not ablated and followed for one year. The primary composite outcome was confirmed or suspected LVAD thrombosis, stroke, or other embolic event. Survival analysis was conducted with Kaplan-Meier curves, log-rank tests, and Cox regression. Forty-three LVAD patients underwent VT ablation, and 73 LVAD patients had VT but were not ablated. Patients who were ablated were more likely have VT prior to LVAD (p = 0.04), monomorphic VT (p < 0.01), and to be on antiarrhythmics (p < 0.01). Fifty-eight percent of the patients in the ablation group experienced the primary composite outcome (11% had confirmed device thrombosis [DT], 41% suspected DT, 39% had a stroke or embolic event) compared to 30% in the control group (12% with confirmed DT, 11% with suspected DT, 14% with stroke or embolic event) (p = 0.002). In multivariable regression, ablation was an independent predictor of the primary composite outcome (hazard ratios, 2.24; 95% confidence interval, 1.09–4.61; p = 0.03). Patients with LVADs referred for endocardial VT ablation had elevated rates of DT and embolic events.
Correction of High Afterload Improves Low Cardiac Output in Patients Supported on Left Ventricular Assist Device Therapy
Authors: Rosenbaum Andrew N. , Clavell Alfredo L. , Stulak John M. , Behfar Atta
Published: March 2020

There is a paucity of data describing the invasive assessment of afterload and influence on cardiac output in patients supported on left ventricular assist device (LVAD) therapy. From 2015 to 2018, patients on LVAD therapy were evaluated with simultaneous left/right heart catheterization ramp study for speed optimization. Hemodynamic parameters from 31 patients without significant aortic insufficiency were analyzed. Mean central aortic pressure (MAP) was elevated at 87 ± 13 mm Hg at baseline. No direct association between MAP and cardiac index (CI) was found (r = 0.11, p = 0.20). However, variable MAP provided vastly different patterns of cardiac output response to speed increments (positive correlation, p = 0.047 for MAP <80 mm Hg; negative trend, p = 0.25 for MAP > 100 mm Hg). Patients noted to be hypertensive (MAP > 90, n = 8) received nitrate therapy and experienced both improvement in biventricular filling pressures and a mean increase in CI from 2.4 to 2.9 L/min/m2 (+22%, p = 0.04) at a fixed revolutions per minute. High afterload is common in patients on LVAD therapy, is associated with poor response to ramp, and is ameliorated by nitrates. These findings serve as a foundation to evaluate the dynamic effects of high afterload and chronic vasodilator therapy in patients with durable LVADs.
Solitary fibrous tumor/hemangiopericytoma in the cerebellopontine angle mimicking vestibular schwannoma
Authors: Yue Xi , Huang Jie , Zhu Yaqi , Du Yong
Published: March 2020

Rationale:

Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are rare spindle cell tumors of mesenchymal origin that include benign and malignant neoplasms.

Patient concerns:

We present a 66-year-old male with a 5-year history of headache and dizziness, with left progressive sensorineural hearing loss over 1 month.

Diagnoses:

WHO grade II SFT/HPC originating from the internal auditory canal in the left cerebellopontine angle.

Interventions:

surgical resection.

Outcomes:

No local recurrence or metastases were observed in the follow-up 3 months after the surgery.

Lessons:

Intracranial SFTs/HPCs are rare mesenchymal neoplasms that are challenging to manage. If the imaging characteristics of tumor are not typical, clinicians should depend on tissue biopsy and immunohistochemistry to make a definitive diagnosis.
Diet Quality Indexes and Health
Authors: Mackerras Dorothy Elizabeth Mary
Published: March 2020

Many different indexes have been developed to describe diet quality. Some are based on the nutrient content of food and specific components that affect metabolic indicators of adverse outcomes. Some indexes identify foods that are characteristic of particular cuisines, whereas other indexes use a mix of foods and nutrients as their basis. The most recent index (NOVA) uses the presence of additives as a marker for classification. Some indexes are intended for health promotion purposes, whereas others are used in regulatory activities, such as front-of-pack labeling. This article examines the literature to determine what information is available on the ability of any index to predict important outcomes such as mortality. Articles were selected if they compared 2 or more indexes or if they described outcomes for any index related to the UK Office of Communication nutrient profiling algorithm or the recently developed NOVA index. Few comparative articles were found. All of the indexes predicted mortality, heart disease, or cancer to some extent. The associations were small and could be due to residual confounding or attenuation due to measurement error. Given the similarity in results across the indexes, other criteria would need to be used when deciding which index to select for any specific context.
Open fractures with soft-tissue loss
Authors: Coles Chad P.
Published: March 2020

Open fractures with soft-tissue loss remain challenging injuries to treat. These often high-energy fractures are at a higher risk of delayed healing and at much higher risk of infection than open fractures with less significant soft-tissue injury. The initial management of the open wound, flap coverage options, and the timing of definitive coverage all remain areas of controversy, which will be discussed in this article.
Open fracture management
Authors: Miclau Theodore
Published: March 2020

Open fractures are commonly encountered injuries worldwide and are often complicated by infection. Many present significant treatment challenges, where surgeons’ early decision-making can affect long-term outcomes. While evidence-based recommendations exist to guide some of these decisions, several treatment areas continue to be controversial. This supplement seeks to outline critical treatment elements for open fractures, including antibiotic administration, surgical timing, bone defect management, and soft-tissue coverage as well as management of fracture-related infections. The expectation is that a better understanding of these issues will help improve the future care of these potentially disabling injuries.
AutoPEWS: Automating Pediatric Early Warning Score Calculation Improves Accuracy Without Sacrificing Predictive Ability
Authors: Lockwood Justin M , Thomas Jacob , Martin Sara , Wathen Beth , Juarez-Colunga Elizabeth , Peters Lisa , Dempsey Amanda , Reese Jennifer
Published: March 2020

Introduction:

Pediatric early warning scores (PEWS) identify hospitalized children at risk for deterioration. Manual calculation is prone to human error. Electronic health records (EHRs) enable automated calculation, removing human error. This study’s objective was to compare the accuracy of automated EHR-based PEWS calculation (AutoPEWS) to manual calculation and evaluate the non-inferiority of AutoPEWS in predicting deterioration.

Methods:

We performed a retrospective cohort study inclusive of non-intensive care unit inpatients at a freestanding children’s hospital over 4.5 months in Fall 2018. AutoPEWS mapped the historical manual PEWS scoring rubric to frequently used EHR documentation. We determined accuracy by comparing the expected respiratory subset score based on the current respiratory rate to the actual respiratory score of AutoPEWS and the manual PEWS. The agreement was determined using kappa statistics. We used predicted probabilities from a generalized linear mixed model to calculate areas under the curve for each combination of scores (AutoPEWS, manual) and deterioration outcome (rapid response team activation, unplanned intensive care unit transfer, critical deterioration event). We compared the adjusted difference in areas under the curves between the scores. Non-inferiority was defined as a difference of <0.05.

Results:

There were 23,514 total PEWS representative of 5,384 patients. AutoPEWS respiratory scores were 99.97% accurate, while the manual PEWS respiratory scores were 86% accurate. AutoPEWS were higher overall than the manual PEWS (mean 0.65 versus 0.34). They showed a fair-to-good agreement (weighted kappa 0.42). Non-inferiority of AutoPEWS compared with the manual PEWS was demonstrated for all deterioration outcomes.

Conclusions:

Automation of PEWS calculation improved accuracy without sacrificing predictive ability.
The Utility of Early Tongue Reduction Surgery for Macroglossia in Beckwith-Wiedemann Syndrome
Authors: Cohen Jennifer L. , Cielo Christopher M. , Kupa Jonida , Duffy Kelly A. , Hathaway Evan R. , Kalish Jennifer M. , Taylor Jesse A.
Published: March 2020

Background:

Macroglossia, a cardinal feature of the (epi)genetic disorder Beckwith-Wiedemann syndrome, is associated with obstructive sleep apnea, speech and/or feeding difficulties, and dental or jaw malalignment. These sequelae may be treated and/or prevented with tongue reduction surgery; the authors sought to determine whether certain Beckwith-Wiedemann syndrome patients may benefit from early surgical intervention before age 12 months.

Methods:

The authors conducted a retrospective review of patients with Beckwith-Wiedemann syndrome who underwent tongue reduction from 2014 to 2019. The authors assessed primary outcomes of change in obstructive sleep apnea by polysomnography, respiratory support required, and feeding route before and after tongue reduction, and reviewed postoperative complications and the need for repeated tongue reduction.

Results:

Of the 36 patients included, the median age at tongue reduction was 9.5 months (interquartile range, 3.8 to 22.8 months). For those with severe obstructive sleep apnea, there was a significant reduction in the obstructive apnea hypopnea index from 30.9 ± 21.8 per hour to 10.0 ± 18.3 per hour (p =0.019) and improvement in nadir oxyhemoglobin saturation from 72 ± 10 percent to 83 ± 6 percent (p =0.008). Although there was no significant change in overall supplemental feeding tube or respiratory support, there were specific patients who experienced clinically meaningful improvement. Of note, these positive outcomes applied equally to those who underwent surgery at a younger age (<12 months). To date, only one patient required a repeated tongue reduction.

Conclusion:

Based on improved polysomnographic findings and rarity of surgical complications or repeated surgery, the authors’ data support the safety and efficacy of this early intervention when clinical indications are present and an experienced multidisciplinary team is available for consultation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Interventions to Improve Hospital Admission and Discharge Management: An Umbrella Review of Systematic Reviews
Authors: Straßner Cornelia , Hoffmann Mariell , Forstner Johanna , Roth Catharina , Szecsenyi Joachim , Wensing Michel
Published: March 2020

Background:

The aim of this umbrella review was to summarize the research evidence on programs to improve the transition between ambulatory and hospital care.

Methods:

The MEDLINE database and the Cochrane library were searched. Systematic reviews of randomized controlled trials published between January 2000 and September 2018 in English or German were included. Studies were eligible if an assessment or coordination intervention had been evaluated and if patients had been transferred between hospital (defined as internal medicine, surgery, or unspecified hospital setting) and home (defined as any permanent residence). Risk of bias was assessed using the AMSTAR criteria. Results are presented descriptively and in table format.

Results:

Thirty-nine systematic reviews comprising 492 different studies were included. More than half of these studies were conducted in the United States, the United Kingdom, Canada, and Australia. All studies evaluated strategies to improve discharge management (introduced after patients' arrival at the hospital); no study assessed strategies to improve admission management (initiated in primary care before patients' transition to hospital). The reviews included focused on a specific patient group, a specific intervention type, or a specific outcome. Overall, interventions focusing on elderly patients and high-intensity interventions seemed to be most effective. An overview of classifications of care transition strategies is provided.

Conclusions:

Future research should focus on hospital admission management programs.
Workflow Improvement and the Use of PDSA Cycles: An Exploration Using Screening, Brief Intervention, and Referral to Treatment (SBIRT) Integration
Authors: Moser Tami , Edwards Jorie , Pryor Frannie , Manson Lesley , O'Hare Caroline
Published: March 2020

Background and Objectives:

The purpose of the study was to use a best practice quality improvement process to identify and eliminate barriers to Screening, Brief Intervention, and Referral to Treatment (SBIRT) integration in a Federally Qualified Health Center. SBIRT provides an initial method for addressing mental health and substance abuse concerns of patients. The method is very useful in integration of behavioral health screening in primary care.

Methods:

A Process Improvement Team used 4 Plan-Do-Study-Act cycles during a 10-week time frame to (1) reduce the reported frequency of barriers to the SBIRT process, (2) reduce non–value-added activities in the SBIRT workflow, (3) reduce bottlenecks, and (4) increase patient receipt of SBIRT. A modified Referral Barriers Questionnaire, a swim lane diagram, non–value-added versus value-added analysis, and a Shewhart control chart (P-chart) were used to evaluate process and outcome measures.

Results:

Nurses reported a 23.82% reduction in referral barrier frequency and a 21.12% increase in the helpfulness of SBIRT. Providers reported a 7.60% reduction in referral barrier frequency and a decrease in the helpfulness of SBIRT. The P-chart indicated that the process changes resulted in a positive shift in behaviors and an increase in patient receipt of SBIRT.

Conclusion:

The use of a best practice quality improvement process resulted in improvements in workflow related to SBIRT, greater communication about SBIRT, and identification of barriers that blocked successful receipt of SBIRT.
Steady-State Multifrequency Magnetic Resonance Elastography of the Thoracic and Abdominal Human Aorta—Validation and Reference Values
Authors: Schaafs Lars-Arne , Schrank Felix , Warmuth Carsten , Steffen Ingo G. , Braun Jürgen , Hamm Bernd , Sack Ingolf , Elgeti Thomas
Published: March 2020

Objectives

The aim of this study was to investigate the potential of stroboscopic-wavefield-sampling-based multifrequency magnetic resonance elastography (sMRE) for quantifying the stiffness of the human thoracic and abdominal aorta in vivo.

Materials and Methods

The sMRE of the thoracic and abdominal aorta was performed at 1.5 T field strength in 20 healthy volunteers aged 27 to 77 years (3 women; median age, 33 years; interquartile range [IQR], 16 years). Compound maps of shear wave speed (SWS) were reconstructed and evaluated during the diastolic phase in 3 anatomical regions: ascending thoracic aorta (AA), descending thoracic aorta (AD), and abdominal aorta (AAb). The SWS maps were read by 2 readers. Blood pressure and pulse wave velocity were determined noninvasively before sMRE. Data are given as median (IQR) and were compared using the Kruskal-Wallis and Wilcoxon rank sum tests. Intraclass correlation was used to determine interobserver and intraobserver agreement, as well as reproducibility. Multiple linear regression analysis was performed to evaluate effects of age, sex, vessel diameter, blood pressure, pulse wave velocity, and aortic segment on measured SWS.

Results

All 20 participants underwent successful sMRE, resulting in a total of 60 aortic segments. The median SWS (IQR) of AA, AD, and AAb was 1.62 (0.16) m/s, 2.40 (0.24) m/s, and 2.48 (0.58) m/s, respectively. The SWS in AA was significantly lower (P < 0.001), and no differences in SWS (P = 0.67) were found between AD and AAb. Interobserver and intraobserver agreement, as well as reproducibility, was excellent, with intraclass correlation coefficients ranging between 0.957 and 0.998. A significant but weak influence of age on measured SWS was found, which increased from AA to AD and AAb (R
2 = 0.229, 0.275, 0.377, respectively; P = 0.001-0.005).

Conclusions

Quantification of aortic stiffness in different segments of the human aorta is possible with sMRE. Our results correlate well with known aortic stiffness differences in different anatomical locations and demonstrate the potential of sMRE for clinical stiffness measurement of the thoracoabdominal aorta, which may allow detection of physiological variation and cardiovascular diseases.
Surgical Outcomes in Patients With Malignant Small Bowel Obstruction
Authors: Song Yun , Metzger Daniel Aryeh , Bruce Adrienne N. , Krouse Robert S. , Roses Robert E. , Fraker Douglas L. , Kelz Rachel R. , Karakousis Giorgos C.
Published: March 2020

Objective:

The study objectives were to characterize surgical outcomes for malignant small bowel obstruction (MaSBO) as compared to other small bowel obstructions (SBO) and to develop a prediction model for postoperative mortality for MaSBO.

Summary Background Data:

MaSBO is a morbid complication of advanced cancers for which the optimal management remains undefined.

Methods:

Patients who underwent surgery for MaSBO or SBO were identified from the National Surgical Quality Improvement Program (2005–2017). Outcomes [30-day morbidity, unplanned readmissions, mortality, postoperative length of stay (LOS)] were compared between propensity score-matched MaSBO and SBO patients. An internally validated prediction model for mortality in MaSBO patients was developed.

Results:

Of 46,706 patients, 1612 (3.5%) had MaSBO. Although MaSBO patients were younger than those with SBO (median 63 vs 65 years, P < 0.001), they were otherwise more clinically complex, including a higher proportion with recent weight loss (22.0% vs 4.0%, P < 0.001), severe hypoalbuminemia (18.6% vs 5.2%, P < 0.001), and cytopenias. After matching (N = 1609/group), MaSBO was associated with increased morbidity [odds ratio (OR) 1.2, P = 0.004], but not readmission (OR 1.1, P = 0.48) or LOS (incidence rate ratio 1.0, P = 0.14). The odds of mortality were significantly higher for MaSBO than SBO (OR 3.3, P < 0.001). A risk-score model predicted postoperative mortality for MaSBO with an optimism-adjusted Brier score of 0.114 and area under the curve of 0.735. Patients in the highest-risk category (11.5% of MaSBO population) had a predicted mortality rate of 39.4%.

Conclusion:

Surgery for MaSBO is associated with substantial morbidity and mortality, necessitating careful patient evaluation before operative intervention.
Impact of Nutrition Knowledge, Dietary Composition, and Eating Behaviors in Adolescents With Type 1 Diabetes
Authors: Folsom Lisal J. , Hannon Tamara S.
Published: March 2020

Research is limited regarding nutritional knowledge and behaviors and glycemic control in adolescents with type 1 diabetes (T1D) and comparisons of nutrition knowledge and behaviors in adolescents with newly diagnosed and established T1D. This study contrasted adolescents with newly diagnosed and established T1D, using a Nutrition Knowledge Score, 24-hour dietary recall, body mass index, and hemoglobin A1c. Fifty adolescents were enrolled, 25 with newly diagnosed T1D and 25 with established T1D. Nutrition knowledge increased and correlated with lower hemoglobin A1c, showing that nutrition knowledge improves after diagnosis and affects glycemic control.
A Current Gap Analysis of Education for Clinical Nutrition Managers
Authors: Howells Amber , Sauer Kevin , Shanklin Carol
Published: March 2020

Clinical nutrition managers (CNMs) administer clinical nutrition and other services. An online survey was distributed to CNMs to examine the importance of education for specific CNM job tasks, the extent to which educational needs are met, and what opportunities exist to enhance the knowledge and skills of CNM practitioners. Gap analyses were employed to interpret variances in the educational variables. Results indicate that CNMs perceive education as important for all job tasks and that educational needs are not being met for all job tasks. The greatest opportunities for education were with ensuring compliance with regulations and accreditation standards and managing human and financial resources.
Safety and Feasibility of Intermittent Fasting During Chemotherapy for Breast Cancer
Authors: Lutes Christine , Zelig Rena , Rigassio Radler Diane
Published: March 2020

Intermittent fasting has been shown to protect healthy cells from chemotherapy toxicity while sensitizing cancer cells, but the extent to which fasting is safe and feasible for individuals during chemotherapy is unknown. The studies reviewed demonstrate that for well-nourished women with breast cancer, intermittent fasting between 24 and 72 hours can be safe and feasible as determined by treatment side effects, blood work, adherence to a fasting protocol, and quality of life. Fasting is not without potential adverse side effects and limitations. Further research is needed to standardize optimal length of fasting and determine whether limited caloric intake is beneficial while fasting during chemotherapy.
Knowledge and Clinical Competence of Nurses Regarding Enteral Nutrition
Authors: Gok Metin Zehra , Pars Hatice
Published: March 2020

This study aimed to explore and compare knowledge and clinical competence of nurses regarding enteral nutrition (EN). Nurses (n = 327) working in clinics from 3 hospitals that use EN were included in the study. Data were collected using a 29-item questionnaire. Half of the nurses (50.0%) reported performing EN assessment. A statistically significant difference was found between the 3 hospitals. Only 2.6% of nurses reported their self-perceived knowledge of EN as “fully” and 12.3% responded “not at all.” The nurses working in private hospitals reported having less self-competence in EN than the nurses working in university and research hospitals. On the basis of the findings, this study revealed that there were important differences between EN practices, nurses' perceived knowledge, and clinical competence regarding EN.
Differential transcription of expanded gene families in central carbon metabolism of Streptomyces coelicolor A3(2)
Authors: Schniete Jana K. , Reumerman Richard , Kerr Leena , Tucker Nicholas P. , Hunter Iain S. , Herron Paul R. , Hoskisson Paul A.
Published: March 2020

Background. Streptomycete bacteria are prolific producers of specialized metabolites, many of which have clinically relevant bioactivity. A striking feature of their genomes is the expansion of gene families that encode the same enzymatic function. Genes that undergo expansion events, either by horizontal gene transfer or duplication, can have a range of fates: genes can be lost, or they can undergo neo-functionalization or sub-functionalization. To test whether expanded gene families in

Streptomyces

exhibit differential expression, an RNA-Seq approach was used to examine cultures of wild-type

Streptomyces coelicolor

grown with either glucose or tween as the sole carbon source.

Results. RNA-Seq analysis showed that two-thirds of genes within expanded gene families show transcriptional differences when strains were grown on tween compared to glucose. In addition, expression of specialized metabolite gene clusters (actinorhodin, isorenieratane, coelichelin and a cryptic NRPS) was also influenced by carbon source.

Conclusions. Expression of genes encoding the same enzymatic function had transcriptional differences when grown on different carbon sources. This transcriptional divergence enables partitioning to function under different physiological conditions. These approaches can inform metabolic engineering of industrial

Streptomyces

strains and may help develop cultivation conditions to activate the so-called silent biosynthetic gene clusters.
Novosphingobium silvae sp. nov., isolated from subtropical forest soil
Authors: Feng Guang-Da , Chen Wendi , Zhang Jun , Wang Yong-Hong , Liu Yang , Zhou Yang , Zhu Honghui
Published: March 2020

A novel bacterial strain, designated FGD1T, was isolated from subtropical forest soil of the Nanling National Forest Park located in Guangdong Province, P.R. China. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain FGD1T was most closely related to

Novosphingobium lindaniclasticum

DSM 25049T (98.8 %), followed by

N. barchaimii

DSM 25411T (98.7 %),

N. guangzhouense

DSM 32207T (98.2 %),

N. panipatense

DSM 22890T (98.1 %) and other species of

Novosphingobium

(<98 %). The draft genome sequence was 4.58 Mb in length with a G+C content of 65.1 mol%. The calculated average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values between strain FGD1T and closely related type strains were 77.7‒79.6 % and 21.7–22.9 %, respectively. Major fatty acids were summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c), summed feature 3 (C16 : 1
 ω7c and/or C16 : 1
 ω6c), C14 : 0 2-OH and C16 : 0. The predominant respiratory quinone was ubiquinone 10 and the major polyamine was spermidine. Polar lipids were composed of sphingoglycolipid, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylmethylethanolamine, diphosphatidylglycerol, an unidentified phospholipid and lipid. The polyphasic taxonomic results indicated that strain FGD1T represents a novel species of the genus

Novosphingobium

, for which the name Novosphingobium silvae sp. nov. is proposed. The type strain is FGD1T (=GDMCC 1.1761T=KACC 21283T).
Investigation of LuxS-mediated quorum sensing in Klebsiella pneumoniae
Authors: Chen Lijiang , Wilksch Jonathan J. , Liu Haiyang , Zhang Xiaoxiao , Torres Von V. L. , Bi Wenzi , Mandela Eric , Cao Jianming , Li Jiahui , Lithgow Trevor , Zhou Tieli
Published: March 2020

Introduction. Autoinducer-2 (AI-2) quorum sensing is a bacterial communication system that responds to cell density. The system requires luxS activity to produce AI-2, which can regulate gene expression and processes such as biofilm formation.

﻿Aim. To investigate the role of luxS in biofilm formation and gene expression in the nosocomial pathogen

Klebsiella pneumoniae

.

﻿Methodology. A ΔluxS gene deletion was made in

K. pneumoniae

KP563, an extensively drug-resistant isolate. AI-2 production was assessed in wild-type and ΔluxS strains grown in media supplemented with different carbohydrates. Potential roles of luxS in biofilm formation were investigated using a microtiter plate biofilm assay and scanning electron microscopy. Quantitative RT-PCR evaluated the expression of lipopolysaccharide (wzm and wbbM), polysaccharide (pgaA), and type 3 fimbriae (mrkA) synthesis genes in wild-type and ΔluxS mutant biofilm extracts.

Results. AI-2 production was dependent on the presence of luxS. AI-2 accumulation was highest during early stationary phase in media supplemented with glucose, sucrose or glycerol. Changes in biofilm architecture were observed in the ΔluxS mutant, with less surface coverage and reduced macrocolony formation; however, no differences in biofilm formation between the wild-type and ΔluxS mutant using a microtiter plate assay were observed. In ΔluxS mutant biofilm extracts, the expression of wzm was down-regulated, and the expression of pgaA, which encodes a porin for poly-β−1,6-N-acetyl-d-glucosamine (PNAG) polysaccharide secretion, was upregulated.

Conclusion. Relationships among AI-2-mediated quorum sensing, biofilm formation and gene expression of outer-membrane components were identified in

K. pneumoniae

. These inter-connected processes could be important for bacterial group behaviour and persistence.
Role of Chloroquine and Hydroxychloroquine in the Treatment of COVID-19 Infection- A Systematic Literature Review
Authors: Kapoor Krishan Mohan , Kapoor Aanandita
Published: March 2020

Background

Coronavirus pandemic is currently a global public health emergency. At present, no pharmacological treatment is known to treat this condition, and there is a need to review the available treatments.

Objective

While there have been studies to describe the role of chloroquine and hydroxychloroquine in various viral conditions, there is limited information about the use of them in COVID-19. This systematic review aims to summarize the available evidence regarding the role of chloroquine in treating coronavirus infection.

Methods

The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used for this review. A literature search was performed using PUBMED & Google Scholar to find articles about the role of CQ in COVID-19 patients.

Results

We included 19 publications (Five published articles, three letters/correspondence, one commentary, five pre-proofs of accepted articles, one abstract of yet to be published article, and four were pre-prints (not yet peer-reviewed) articles) in this systematic review. All the articles mentioned about the role of chloroquine and /or hydroxychloroquine in limiting the infection with SARS-CoV-2 (the virus causing COVID-19).

Conclusions

There is theoretical, experimental, preclinical and clinical evidence of the effectiveness of chloroquine in patients affected with COVID-19. There is adequate evidence of drug safety from the long-time clinical use of chloroquine and hydroxychloroquine in other indications. More data from ongoing and future trials will add more insight into the role of chloroquine and hydroxychloroquine in COVID-19 infection.
Machine Learning Approach for Confirmation of COVID-19 Cases: Positive, Negative, Death and Release
Authors: Dutta Shawni , Bandyopadhyay Samir Kumar
Published: March 2020

In recent days, Covid-19 coronavirus has been an immense impact on social, economic fields in the world. The objective of this study determines if it is feasible to use machine learning method to evaluate how much prediction results are close to original data related to Confirmed-Negative-Released-Death cases of Covid-19. For this purpose, a verification method is proposed in this paper that uses the concept of Deep-learning Neural Network. In this framework, Long short-term memory (LSTM) and Gated Recurrent Unit (GRU) are also assimilated finally for training the dataset and the prediction results are tally with the results predicted by clinical doctors. The prediction results are validated against the original data based on some predefined metric. The experimental results showcase that the proposed approach is useful in generating suitable results based on the critical disease outbreak. It also helps doctors to recheck further verification of virus by the proposed method. The outbreak of Coronavirus has the nature of exponential growth and so it is difficult to control with limited clinical persons for handling a huge number of patients with in a reasonable time. So it is necessary to build an automated model, based on machine learning approach, for corrective measure after the decision of clinical doctors. It could be a promising supplementary confirmation method for frontline clinical doctors. The proposed method has a high prediction rate and works fast for probable accurate identification of the disease. The performance analysis shows that a high rate of accuracy is obtained by the proposed method.
Laboratory findings, signs and symptoms, clinical outcomes of Patients with COVID-19 Infection: an updated systematic review and meta-analysis
Authors: Ebrahimi Mina , Malehi Amal Saki , Rahim Fakher
Published: March 2020

Background and Aim

Coronaviruses disease 2019 (COVID-19), for the first time detected in Wuhan, China, rapidly speared around the world and be a Public Health Emergency of International Concern (PHEIC). The aim of the current survey is collecting laboratory findings, analysis them and reporting a specific pattern for help to COVID-19 diagnosis.

Methods

To collect laboratory characteristics, we searched “PubMed” electronic database with the following keywords: “COVID-19” “2019 novel coronavirus” “laboratory findings” “clinical characteristics”.

Results

Once the initial searches 493 studies were yielded. After removing duplicates studies 480 studies were remained. The 12 studies obtained from the literature, of which 58.3% (7) of studies were case-control (8–14), and 41.7% (5) remaining studies were designed as cross-sectional (1,15–18)

Conclusion

The result of the current study showed that in the early stage of COVID-19 infection, maybe there are not significant laboratory findings, but with disease progression, the one or more than signs include increasing AST, ALT, LDH, CK, CRP, ESR, WBC, neutrophil, and decreasing Hemoglobin, lymphocyte count, eosinophil count can be seen. Elevating D-dimer and FDP are associated with ARDS development and can be used as prognostic factors.
Dangers of ACE inhibitor and ARB usage in COVID-19: evaluating the evidence
Authors: Sriram Krishna , Insel Paul A.
Published: March 2020

Background

Concerns have been raised regarding the safety of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) in patients with COVID-19, based on the hypothesis that such medications may raise expression of ACE2, the receptor for SARS-CoV-2.

Methods

We conducted a literature review of studies (n=12) in experimental animals and human subjects (n=12) and evaluated the evidence regarding the impact of administration of ACEIs and ARBs on ACE2 expression. We prioritized studies that assessed ACE2 protein expression data, measured directly or inferred from ACE2 activity assays.

Results

The findings in animals are inconsistent with respect to an increase in ACE2 expression in response to treatment with ACEIs or ARBs. Control/sham animals show little to no effect in the plurality of studies. Those studies that report increases in ACE2 expression tend to involve acute injury models and/or higher doses of ACEIs or ARBS than are typically administered to patients. Data from human studies overwhelmingly imply that administration of ACEIs/ARBs does not increase ACE2 expression.

Conclusion

Available evidence, in particular, data from human studies, does not support the hypothesis that ACEI/ARB use increases ACE2 expression and the risk of complications from COVID-19. We conclude that patients being treated with ACEIs and ARBs should continue their use for approved indications.