bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupuncture for post-stroke insomnia
Authors: Xiang Jie , Li Honglian , Xiong Jun , Hua Fanghui , Huang Shouqiang , Jiang Yunfeng , Zhou Xiaohong , Liao Kai , Xu Lingling
Published: July 2020

Background:

Post-stroke insomnia (PSI) is a significant complication of stroke, which often affects patients in various aspects. Acupuncture has fewer side effect and is increasingly used to treat PSI. The purpose of this study is to summarize the efficacy and safety of acupuncture for PSI.

Methods:

We will perform a comprehensive electronic searching, including PubMed, Embase, Cochrane Library, WangFang Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, from inception to July 2020. We will also manually retrieve references, and contact lead authors. Randomized clinical trials (RCTs) of acupuncture for PSI will be included, regardless of whether blind method and allocation concealment are used. The outcomes of interest include: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), efficacy standards of Chinese medicine, relapse rate after follow-up, adverse events, quality of life. To assess the risk of bias, we will use the Cochrane risk assessment tool. RevMan 5.3 software will be used to conduct data synthesis. The evidence quality of each outcome will be appraised according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).

Results:

The results will be published in a peer-reviewed journal.

Conclusion:

This study will provide a high-quality evidence to evaluate the efficacy and adverse reactions of acupuncture for PSI.

PROSPERO registration number:

CRD42020157865.
Optical coherence tomographic findings of ocular siderosis following intraocular foreign body removal
Authors: Lee You Hyun , Kim Yu Cheol
Published: July 2020

Rationale:

Ocular siderosis is arrested by the removal of intraocular foreing body (IOFB). The progression of ocular siderosis is very rare and few reports demonstrate the optical coherence tomographic (OCT) findings.

Patient concerns:

A 55-year-old Asian man presented to our clinic with the chief complaint of decreased vision in his left eye for 5 months. On slit lamp examination of the left eye, the corneal stroma had a rust-colored hue, and the retina was not visible due to vitreous opacity. An orbital computed tomography was ordered considering the possibility of left IOFB, which confirmed the presence of a vitreous IOFB. On the next day, he had a continuous curvilinear capsulorrhexis with phacoemulsification and intraocular lens implantation, pars plana vitrectomy, and removal of IOFB in the left eye. Six years later, he revisited our clinic. On slit lamp examination, the corneal haziness had worsened, and the iris showed heterochromia resembling the spokes of a wheel in the left eye.

Diagnosis:

Ocular siderosis.

Intervention:

Anterior and posterior segment OCT was performed.

Outcomes:

The anterior segment OCT showed linear hyperreflectivity on the anterior corneal stroma just beneath the Bowman's layer. The posterior segment OCT showed inner retinal degeneration observed at the parafoveal area.

Lessons:

Ocular siderosis progression can happen after the removal of IOFB. The swept source OCT might be useful to assess the cornea and retina in ocular siderosis patient with corneal haziness.
Anesthesia for pulmonary veno-occlusive disease: the dilemma and what we should know as anesthesiologists
Authors: Foong Theng Wai , Tan Pei Shan , Thampi Swapna , Balakrishnan Ashokka
Published: July 2020

Introduction:

Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension. It is often underdiagnosed or misdiagnosed as idiopathic pulmonary arterial hypertension (PAH). Inappropriate treatment may cause worsening of symptoms which may lead to fatal outcomes. Anesthetic considerations and management for pulmonary hypertension are well described, but few anesthesiologists are aware of the entity of PVOD and its management.

Patient concerns:

We report a case of PVOD in a 73-year-old female who was on concurrent aspirin and anagrelide, requiring emergent open femoral hernia repair.

Diagnosis:

PVOD and incarcerated femoral hernia

Intervention:

Combined spinal-epidural (CSE) was performed to enable the surgery.

Outcome:

Surgery was completed successfully under central neuraxial anesthesia and the patient remained stable and comfortable throughout, avoiding the need for general anesthesia. Due to the concurrent aspirin and anagrelide therapy, significant bleeding from the CSE puncture site was observed immediately post-operatively. This was resolved with external manual compression and withholding the aspirin and anagrelide. Patient remained well without neurological deficit and was discharged postoperative day seven.

Lessons:

It is important to differentiate PVOD from PAH due to the controversial use of pulmonary vasodilators in PVOD. Pulmonary vasodilator is commonly used to treat acute pulmonary hypertension in PAH but its usage may lead to pulmonary edema in patients with PVOD. Hence, with no ideal treatment available, the avoidance of general anesthesia is crucial to prevent acute pulmonary hypertensive crisis in patient with PVOD. However, this needs to be weighed against the elevated risk of central neuraxial bleeding when performing a CSE in a patient on concurrent aspirin and anagrelide therapy. Calculated decision-making considering the risks and benefits of all alternatives should be carried out in such a scenario, and measures should be taken in anticipation of the potential consequences of the eventual decision.

Conclusion:

It is important to differentiate PVOD from PAH. PVOD has unique anesthetic considerations due to the controversial use of pulmonary vasodilators. This case also emphasizes the importance of active anticipation of potential issues and adequate follow up.
Validation protocol for current good manufacturing practices production of [15O]water for hybrid PET/MR studies
Authors: Cockburn Neil , Corsaut Jeffrey , Kovacs Michael S. , St. Lawrence Keith , Hicks Justin W.
Published: July 2020

Introduction

Oxygen-15 (15O; t½ = 122.4 s) has been used for nuclear imaging experiments since the beginning of the field. With the advent of simultaneous hybrid PET/MR technology, [15O]water has seen a resurgence and remains the gold standard method for quantitative blood flow studies. The short half-life presents a nontrivial challenge to applying current good manufacturing practices production methods to maintain patient safety.

Methods

A two-vial production method was devised to ensure adequate mixing of [15O]water vapour into buffered isotonic saline. For production validation, six batches of [15O]water were prepared: sterility, quality control testing and four patient doses. The final dose also underwent quality tested. Routine quality control testing included the following: radiochemical identity and purity, radionuclidic identity and purity, appearance, pH, pyrogenicity, and filter integrity. Sterility was retrospectively confirmed. For validation, breakthrough Pt concentration was also measured.

Results

Consistent yields of 10–12 GBq (270–325 mCi) were obtained 3 min after bombardment. Overall, 26 [15O]water batches underwent quality control testing under this protocol and all met or exceeded release specifications for clinical use.

Conclusion

The multiple batch protocol proved to be a safe and effective means for producing [15O]water. Furthermore, this protocol could be readily adapted by any facility attempting to produce [15O]water for clinical studies. Compared with previous attempts at our site, the protocol outlined here was more consistent and reliable, improved production workflow and led to more available radioactivity for participant injection and QC testing.
Feasibility and Acceptability of a Self-Management Program for Patients With Rheumatoid Arthritis
Authors: Shao Jung-Hua , Yu Kuang-Hui , Chen Su-Hui
Published: July 2020

BACKGROUND:

Joint activity and protection are key components in the management of rheumatoid arthritis (RA). Despite a shift from care in health settings to empowering patients to play an active role in the day-to-day management of their own chronic conditions, there is little evidence on RA self-management, especially for Chinese patients.

PURPOSE:

This pilot study sought to determine the feasibility and acceptability of a self-management program for patients with RA in Taiwan.

METHODS:

Participants were recruited at a medical center in northern Taiwan. The intervention group participated in a 6-week self-management program; the control group received standard rheumatology care. Both groups underwent baseline assessments before the intervention and at 12 weeks.

RESULTS:

A total of 32 participants were recruited: 15 in the intervention group and 17 in the control group. Patients in the intervention group found the self-management protocol beneficial to their joint protection and activity behaviors and reported higher motivation to perform RA self-management. The posttest score for joint protection and activity self-management behavior were significantly greater for the intervention group than for the control group (p = .02).

CONCLUSIONS:

Participants in the intervention group were highly satisfied with home visits (which included peer story-telling and goal setting) and telephone calls to support their daily home-based joint protection and self-management activities (which included self-monitoring and self-evaluation). To mitigate the fear of scammers, researchers should begin by building a trust relationship with participants.
Demystifying Cannabis
Authors: Dume Roberta , Lammers Emily
Published: July 2020

The uses for cannabis and its synthetic derivatives continue to grow, as the regulatory status surrounding the drug becomes more legalized. Cannabis is composed of many chemical compounds, called cannabinoids, of which cannabidiol and 9-tetrahydrocannabinol have been studied for medicinal uses. As a modality for treatment of pain, cannabis may have benefit for use in treatment of neuropathic pain, with limited data for use in rheumatic pain. However, there are both short-term and long-term adverse effects with cannabis use that should be monitored in those who use cannabis for medicinal purposes, which include worsened anxiety and potential development of cannabis use disorder.
Sustained, Low Prevalence of Undiagnosed HIV Among Gay and Bisexual Men in Sydney, Australia Coincident With Increased Testing and Pre-exposure Prophylaxis Use: Results From Repeated, Bio-Behavioral Studies 2014–2018
Authors: Keen Phillip , Lee Evelyn , Grulich Andrew E. , Prestage Garrett , Guy Rebecca , Stoové Mark A. , Bavinton Benjamin R. , Asselin Jason , Hammoud Mohamed A. , Broady Tim , Duck Tim , Holt Martin ,   on behalf of the NSW HIV Prevention Partnership Project
Published: July 2020

Background:

Gay and bisexual men with undiagnosed HIV contribute disproportionately to HIV transmission in Australia.

Methods:

In 2014 and 2018, we recruited men at gay venues and events in Sydney. Participants self-completed surveys and provided oral fluid samples for HIV testing. We calculated the prevalence of HIV and undiagnosed infection, and assessed changes in behavior, HIV testing, and the use of pre-exposure prophylaxis. We weighted the samples to adjust for differences in where participants were recruited between rounds. Two-sample tests of proportion were used to compare prevalence estimates and χ2 tests to assess differences between the samples.

Results:

In 2014, 944 men were recruited, and 890 men were recruited in 2018. In 2014, the weighted estimate of HIV prevalence was 6.1% [95% confidence intervals (CI): 4.6 to 7.6], of which 13.8% (95% CI: 5.0 to 22.7) was undiagnosed. In 2018, weighted HIV prevalence was 6.4% (95% CI: 4.8 to 8.0), of which 5.3% (95% CI: 0.5 to 11.1) was undiagnosed. Between 2014 and 2018 among all participants, men reporting at least 10 recent casual partners increased from 22.3% to 27.7% (P = 0.008), condomless anal intercourse with casual partners in the previous 6 months increased from 23.9% to 37.3% (P < 0.001), and sexually transmitted infection diagnoses in the previous year increased from 14.4% to 27.5% (P < 0.001). HIV testing and the use of pre-exposure prophylaxis in the previous 6 months increased from 49.6% to 56.3% (P = 0.004) and 2.0%–21.0% (P < 0.001), respectively.

Conclusions:

Repeated, bio-behavioral surveillance suggests the prevalence of undiagnosed HIV remains low in Sydney, despite gay and bisexual men reporting more casual sex partners, condomless sex, and sexually transmitted infections.
Composite Face Lifting
Authors: Sterodimas Aris , Nicaretta Beatriz , Boriani Filippo
Published: July 2020

Background

Face rejuvenation is increasingly challenging because patients request minimally invasive surgery; rapid surgical course and recovery; and fast, tangible, and long-term results. Rejuvenation of face often requires surgery to multiple areas, that is, the lateral face, the midface, the neck, and periorbital areas, in addition to the emerging procedures of face volumizing and biostimulation through fat injection. At our institution, a systematic approach comprising all of these procedures has been developed, with consistent results.

Objective

The aim of this study was to describe the combination of blepharoplasty, minilift, and Stromal Enriched Lipograft (SEL) for thorough rejuvenation of face and neck regions.

Methods

A prospective study was performed to evaluate outcomes and patient satisfaction with composite face lifting, comprising upper and lower blepharoplasties, minilift, and SEL in 210 patients between 2009 and 2018. Overall improvement after the procedure was rated on a scale of 1 to 5, where 1 is “poor,” 2 is “fair,” 3 is “good,” 4 is “very good,” and 5 is “excellent.” The evaluation was expressed at 6 months postoperatively by the patient.

Results

The amount of SEL transplanted varied from 22 to 56 mL per side (mean, 41). There were no cases of liponecrosis, infection of the grafted area, or pulmonary embolism. More than 85% of patients expressed a very good to excellent evaluation of the result obtained. No one expressed a degree of satisfaction less than good.

Conclusions

Composite face lifting seems as a safe and effective combined procedure for the rejuvenation of face. Face harmony not only depends on redraping tissues toward a more natural, tense, and young conformation, but also on restoring volumes and improving the quality of the redraped tissues. More research is necessary, but the preliminary encouraging impression is that the composite face lifting is capable of addressing all issues, the necessity of correcting laxity, filling volumes, and improving the quality of cutaneous tissues.
Maxillofacial Trauma in Geriatric Population
Authors: Aytaç Ismail , Yazici Alper , Tunç Orhan
Published: July 2020

Background/Aim:

The worldwide population is increasingly aging. Maxillofacial fractures of the geriatric population have been increased. Evaluation of the demographic variables, causes and the patterns of maxillofacial traumas in the elderly population is the main aim of this study.

Materials and Methods:

Seven hundred thirteen maxillofacial tomography images which were scanned between 2010 and 2019 were evaluated. Data from 50 patients aged 65 years old and/or older, who were treated for maxillofacial fracture at the Department of Otorhinolaryngology, Gaziantep University, were retrospectively analyzed. Two groups were created according to the facial fracture pattern. Facial fractures were reclassified into 2 groups; mandibula, orbital, zygomaticomaxillary complex group fractures and the other group of frontal, naso-orbito-ethmoid fractures and were used as a comparison.

Results:

The mean age of the patients was 72.5 (min 65- max 93). The gender distribution was 17 females (34%) and 33 males (66%). The most common fractured bone was the nasal bone and the least one is the frontal bone. Approximately one-quarter of 50 fractures were seen in 70 to 79 years old. Falling is more common in females and men are more prone to work-related accidents than home-related accidents.

Conclusion:

Facial fractures in the elderly often seen in midface location. Falling is the common etiology of facial fracture in all genders at elderly. However, male dominance is seen in other etiological factors. Additional diseases in the elderly seem to increase the severity of facial fracture.
African Americans Struggle With the Current COVID-19
Authors: Kandil Emad , Attia Abdallah S. , Youssef Mohanad R. , Hussein Mohammad , Ibraheem Kareem , Abdelgawad Mohamed , Al-Qurayshi Zaid , Duchesne Juan
Published: July 2020

Objectives:

Our study aims to explore the differential impact of this pandemic on clinical presentations and outcomes in African Americans (AAs) compared to white patients.

Background:

AAs have worse outcomes compared to whites while facing heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, and HIV/AIDS. However, there is no current study to show the impact of COVID-19 pandemic on the AA communities.

Methods:

This is a retrospective study that included patients with laboratory-confirmed COVID-19 from 2 tertiary centers in New Orleans, LA. Clinical and laboratory data were collected. Multivariate analyses were performed to identify the risk factors associated with adverse events.

Results:

A total of 157 patients were identified. Of these, 134 (77%) were AAs, whereas 23.4% of patients were Whites. Interestingly, AA were younger, with a mean age of 63 ± 13.4 compared to 75.7 ± 23 years in Whites (P < 0.001). Thirty-seven patients presented with no insurance, and 34 of them were AA. SOFA Score was significantly higher in AA (2.57 ± 2.1) compared to White patients (1.69 ± 1.7), P = 0.041. Elevated SOFA score was associated with higher odds for intubation (odds ratio = 1.6, 95% confidence interval = 1.32–1.93, P < 0.001). AA had more prolonged length of hospital stays (11.1 ± 13.4 days vs 7.7 ± 23 days) than in Whites, P = 0.01.

Conclusion:

AAs present with more advanced disease and eventually have worse outcomes from COVID-19 infection. Future studies are warranted for further investigations that should impact the need for providing additional resources to the AA communities.
Impact of Prolonged Neoadjuvant Treatment–surgery Interval on Histopathologic and Operative Outcomes in Patients Undergoing Total Mesorectal Excision for Locally Advanced Rectal Cancer
Authors: Akbaba Ata C. , Zenger Serkan , Aytac Erman , Yozgatli Tahir K. , Bengür Fuat B. , Esen Eren , Bilgin Ismail A. , Sahin Bilgehan , Atalar Banu , Sezen Duygu , Erdamar Sibel , Kapran Yersu , Ozben Volkan , Baca Bilgi , Balik Emre , Hamzaoglu Ismail , Bugra Dursun , Karahasanoglu Tayfun
Published: July 2020

Background:

This study primarily aimed to assess the impact of prolonged neoadjuvant treatment–surgery interval (PNSI) on histopathologic and postoperative outcomes. Impacts of the mode of neoadjuvant treatment (NT) and surgery on the outcomes were also evaluated in the same patient population.

Patients and Methods:

Between February 2011 and December 2017, patients who underwent NT and total mesorectal excision for locally advanced rectal cancer were included. PNSI was defined as >4 and >8 weeks after short-course and long-course NT modalities, respectively.

Results:

A total of 44 (27%) patients received short-course NT (standard interval: n=28; PNSI: n=16) and 122 (73%) patients received long-course NT (standard interval: n=39; PNSI: n=83). Postoperative morbidity was similar between the standard interval and PNSI in patients undergoing short-course [n=3 (11%) vs. n=3 (19%), P=0.455] and long-course [n=6 (15%) vs. n=16 (19%), P=0.602] NT. PNSI was associated with increased complete pathologic response in patients receiving short-course NT [0 vs. n=5 (31%), P=0.002]. Compared with short-course NT, long-course NT was superior in terms of tumor response based on the Mandard [Mandard 1 to 2: n=6 (21%) vs. 6 (38%), P=0.012] and the College of American Pathologists (CAP) [CAP 0 to 1: n=13 (46%) vs. n=8 (50%), P=0.009] scores. Postoperative morbidity was similar after open, laparoscopic, and robotic total mesorectal excision [n=1 (14.2%) vs. n=21 (21%) vs. n=6 (12.5%), P=0.455] irrespective of the interval time to surgery and the type of NT.

Conclusions:

PNSI can be considered in patients undergoing short-course NT due to its potential oncological benefits. The mode of surgery performed at tertiary centers has no impact on postoperative morbidity after both NT modalities.
Perioperative Outcomes of Minimally Invasive Esophagectomy Versus Open Esophagectomy: A Meta-Analysis of Randomized Controlled Trials
Authors: Memon Muhammed A. , Yunus Rossita M.
Published: July 2020

Background:

To explore the perioperative outcomes, safety, and effectiveness of minimally invasive esophagectomy (MIE) versus open esophagectomy (OE).

Materials and Methods:

Randomized controlled comparing MIE versus OE were searched from PubMed and other electronic databases between January 1991 and March 2019. Thirteen outcome variables were analyzed. Random effects model was used to calculate the effect size. The meta-analysis was prepared in accordance with PRISMA guidelines.

Results:

Four randomized controlled trials totaling 569 patients were analyzed. For MIE, there was a significantly reduction of 67% in the odds of pulmonary complications. For operating time, MIE was nonsignificantly 29 minutes longer. MIE was associated with nonsignificantly less blood loss of 443.98 mL. There was nonsignificant 60% reduction in the odds of total complications and 51% reduction in the odds of medical complications favoring MIE group. For delayed gastric emptying, there was a nonsignificant reduction of 75% in the odds ratio favoring the MIE group. For postoperative anastomotic leak, there was a nonsignificant increase of 48% in the odds ratio for MIE group. For gastric necrosis, chylothorax, reintervention and 30-day mortality, no difference was observed for both groups. There was a nonsignificant reduction in the length of hospital stay of 7.98 days and intensive care unit stay of 2.7 days favoring MIE.

Conclusions:

MIE seems to be superior to OE for only pulmonary complications. All the other perioperative variables were comparable however, the trend is favoring the MIE. Therefore, the routine use of MIE presently may only be justifiable in high volume esophagogastric units.
Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series
Authors: Goussous Naeem , Xie Wen , Dawany Noor , Scalea Joseph R. , Bartosic Amanda , Haririan Abdolreza , Kalil Roberto , Drachenberg Cinthia , Costa Nadiesda , Weir Matthew R. , Bromberg Jonathan S.
Published: July 2020

Background.

Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications.

Methods.

Retrospective review of all renal transplant recipients who underwent dd-cfDNA testing between November 2017 and August 2019.

Results.

We report on 7 cases in whom infections affecting the transplanted kidney were associated with elevation in dd-cfDNA without concomitant rejection or elevation in serum creatinine. Five patients had BK viremia, and 2 patients had urinary tract infection associated with elevated dd-cfDNA levels.

Conclusions.

These observations suggest that elevations in dd-cfDNA are not specific to kidney allograft rejection and can be associated with infections affecting the transplanted kidney. This biomarker may be valuable in evaluating infectious complications of kidney allografts.
Educational Animations to Inform Transplant Candidates About Deceased Donor Kidney Options: An Efficacy Randomized Trial
Authors: Kayler Liise K. , Dolph Beth A. , Cleveland Chelsea N. , Keller Maria M. , Feeley Thomas H.
Published: July 2020

Background.

Transplant candidates struggle making decisions about accepting kidneys with variable kidney donor profile index (KDPI) and increased risk donor (IRD) status.

Methods.

This single site, pilot randomized controlled trial evaluated the efficacy of 2 animations to improve KDPI/IRD knowledge, decisional self-efficacy, and willingness. Kidney candidates were randomly assigned to animation viewing plus standard nurse discussion (intervention) or standard nurse discussion alone (control). Linear regression was used to test the significance of animation exposure after controlling for covariates (α < 0.1).

Results.

Mean age was 60 years, and 27% were African American. Both intervention (n = 42) and control (n = 38) groups received similar education at similar duration (12.8 versus 11.8 min, respectively), usually by the same dedicated nurse educator (85% versus 75%, respectively). On multivariate analysis, the intervention group (versus control) exhibited significantly increased knowledge (β = 0.23; 95% confidence interval, 0.66-1.77) and IRD willingness (β = 0.22; 95% confidence interval, 0.05-0.86). There were no between-group differences in KDPI >85% willingness or distribution of KDPI/IRD decisional self-efficacy. Over 90% of participants provided positive ratings on each of 11 acceptability items.

Conclusions.

Supporting conventional IRD and KDPI education with educational animations can improve knowledge and IRD willingness compared with standard methods.
Evaluation of Malnutrition Risk in Lung Transplant Candidates Using the Nutritional Risk Index
Authors: Chohan Karan , Park Jeff , Dales Sarah , Varughese Rhea , Wickerson Lisa , Singer Lianne G. , Stewart Brooke , Rozenberg Dmitry
Published: July 2020

Background.

Malnutrition in lung transplant (LTx) candidates is an important risk factor for adverse outcomes. We sought to evaluate the Nutritional Risk Index (NRI) in LTx candidates, a validated measure of malnutrition risk in chronic disease. We aimed to characterize malnutrition risk using NRI, evaluate change in body weight between nutritional risk groups, and assess association of malnutrition risk with pretransplant and posttransplant outcomes.

Methods.

Retrospective, single-center cohort study of LTx candidates (2014–2015) evaluated by a dietitian before listing. Nutritional parameters, weight change pretransplant and posttransplant, and clinical outcomes were abstracted up to 1-year posttransplant. NRI was calculated as follows: (1.519 × albumin) + (41.7 × current weight/ideal weight) with high malnutrition risk defined as the lowest quartile of NRI for cystic fibrosis (CF) and non-CF patients.

Results.

The cohort comprises 247 LTx candidates (57% male; median age 59 y; non-CF 88%). Non-CF candidates had a greater mean NRI compared with CF patients (109 ± 11 versus 95 ± 12; P < 0.0001). 86% with high malnutrition risk maintained/gained weight (≥5%) pretransplant. In 196 LTx recipients, malnutrition risk was not associated with hospital stay, discharge disposition, or 1-year mortality. The median percent weight gain for LTx recipients in the first year was 10.5% (4.0–20.1), with high malnutrition risk recipients having comparable or greater weight gain to the low-risk group (mean difference for non CF: 6.8%; P = 0.02 and CF: −3.8%; P = 0.65).

Conclusions.

Malnutrition risk assessed with NRI was not prognostic of posttransplant outcomes in this retrospective cohort. LTx candidates with high malnutrition risk were able to maintain their weight pretransplant and demonstrated considerable weight gain in the first-year posttransplant.
Houseflies and fungi: the promise of an early twentieth-century biotechnology
Authors: Holmes Matthew
Published: July 2020

Despite a surge of recent scholarship on the long and broad history of biotechnology, the use of biological controls such as fungal and insect vectors does not immediately spring to mind when considering early attempts to engineer life. Yet the early twentieth century saw an ambitious attempt to artificially cultivate and disseminate the parasitic
Empusa muscae
fungus to destroy the housefly (
Musca domestica
). This paper argues that
E. muscae
represented an early twentieth-century disconnect between the promised hopes of biological control and the problematic reality of its use. During the late nineteenth century, bacteriological techniques established that the housefly spread disease, while biological controls were trialled against locusts and other insects in North America and South Africa. In 1912, Edgar Hesse successfully cultivated
E. muscae
at the Working Men's College in London. His ambition to use the fungus to exterminate the housefly was short-lived, thwarted by technical difficulties and the realization that the fungus also carried harmful pathogens. Although the use of
E. muscae
ultimately proved a failure, its history offers us a glimpse of a little-known, yet surprisingly familiar, world of biotechnological aspiration and controversy.
Early Robert Grosseteste on Matter
Authors: Polloni Nicola
Published: July 2020

This article investigates the origin of Robert Grosseteste's theory of matter. Covering Grosseste's early production, from his
De artibus liberalibus
to
De luce
and the
Commentarius
on Aristotle's
Physics
, his gradual developing of a philosophical theory of matter and prime matter is examined by means of his progressive study of the works of the Aristotelian tradition. Surprisingly, Grosseteste's first notion of matter is bound to alchemy and astrology. It is a physical notion of matter as subject to astral influence and human manipulation. Only with his study of Aristotle's
Physics
does Grosseteste elaborate a more Aristotelian theory of matter, directly engaging himself with the manifold problems of assimilating Aristotle's theories into a Christian-based speculation. As a consequence, a much-refined version of his theory of matter is presented in the commentary on the
Physics
and
De luce
, where prime matter is envisioned as an extensionless point containing in itself the possibility of the existence of the entire universe. Notwithstanding the gradually more philosophical attitude marking Grosseteste's reflection, some tension between the alchemical and metaphysical epistemes of matter he engaged with can be appreciated throughout much of his early production.
Anti-cancer peptides: classification, mechanism of action, reconstruction and modification
Authors: Xie Mingfeng , Liu Dijia , Yang Yufeng
Published: July 2020

Anti-cancer peptides (ACPs) are a series of short peptides composed of 10–60 amino acids that can inhibit tumour cell proliferation or migration, or suppress the formation of tumour blood vessels, and are less likely to cause drug resistance. The aforementioned merits make ACPs the most promising anti-cancer candidate. However, ACPs may be degraded by proteases, or result in cytotoxicity in many cases. To overcome these drawbacks, a plethora of research has focused on reconstruction or modification of ACPs to improve their anti-cancer activity, while reducing their cytotoxicity. The modification of ACPs mainly includes main chain reconstruction and side chain modification. After summarizing the classification and mechanism of action of ACPs, this paper focuses on recent development and progress about their reconstruction and modification. The information collected here may provide some ideas for further research on ACPs, in particular their modification.
Speed oscillations in classical pilot-wave dynamics
Authors: Durey Matthew , Turton Sam E. , Bush John W. M.
Published: July 2020

We present the results of a theoretical investigation of a dynamical system consisting of a particle self-propelling through a resonant interaction with its own quasi-monochromatic pilot-wave field. We rationalize two distinct mechanisms, arising in different regions of parameter space, that may lead to a wavelike statistical signature with the pilot-wavelength. First, resonant speed oscillations with the wavelength of the guiding wave may arise when the particle is perturbed from its steady self-propelling state. Second, a random-walk-like motion may set in when the decay rate of the pilot-wave field is sufficiently small. The implications for the emergent statistics in classical pilot-wave systems are discussed.
Observational Study of the Efficiency of Treatments in Patients Hospitalized with Covid-19 in Madrid
Authors: Bernaola Nikolas , Mena Raquel , Bernaola Ander , Carballo Cesar , Lara Antonio , Bielza Concha , Larrañaga Pedro
Published: July 2020

Background

Many different treatments were heavily administered to patients with COVID-19 during the peak of the pandemic in Madrid without robust evidence supporting them.

Methods

We examined the association between sixteen treatments in four groups (steroids, antivirals, antibiotics and immunomodulators) and intubation or death. Data were obtained from patients that were admitted to an HM hospital with suspicion of COVID-19 until 24/04/2020, excluding unconfirmed diagnosis, those who were admitted before the epidemic started in Madrid, had an outcome that was not discharge or death or died within 24 hours of presentation. We compared outcomes between treated and untreated patients using propensity-score caliper matching.

Results

Of 2,307 patients in the dataset, 679 were excluded. Of the remaining 1,645 patients, 263 (16%) died and 311 (18.9%) died or were intubated. Except for hydroxychloroquine and prednisone, patients that were treated with any of the medications were more likely to go through an outcome of death or intubation at baseline. After propensity matching we found an association between treatment with hydroxychloroquine and prednisone and better outcomes (hazard ratios with 95% CI of 0.83 ± 0.06 and 0.85 ± 0.03). Results were similar in multiple sensitivity analyses.

Conclusions

In this multicenter study of patients admitted with COVID-19 hydroxychloroquine and prednisone administration was found to be associated with improved outcomes. Other treatments were associated with no effect or worse outcomes. Randomized, controlled trials of these medications in patients with COVID-19 are needed to avoid heavy administration of treatments with no strong evidence to support them.
Adaptive short term COVID-19 prediction for India
Authors: Jana Shuvrangshu , Ghose Debasish
Published: July 2020

In this paper, a data-driven adaptive model for infection of COVID-19 is formulated to predict the confirmed total cases and active cases of an area over 4 weeks. The parameter of the model is always updated based on daily observations. It is found that the short term prediction of up to 3-4 weeks can be possible with good accuracy. Detailed analysis of predicted value and the actual value of confirmed total cases and active cases for India from 1st June to 3rd July is provided. Prediction over 7, 14, 21, 28 days has the accuracy about 0.73% ± 1.97%, 1.92% ± 2.95%, 4.34% ± 3.91%, 6.40% ± 9.26% of the actual value of confirmed total cases. Similarly, the 7, 14, 21, 28 days prediction has the accuracy about 1.24% ± 6.57%, 3.04% ± 10.00%, 6.33% ± 16.12%, 10.20% ± 24.14% of the actual value of confirmed active cases.
Neutralizing and binding antibody kinetics of COVID-19 patients during hospital and convalescent phases
Authors: Yao Xiang-Yang , Liu Wei , Li Zhi-Yong , Xiong Hua-Long , Su Ying-Ying , Li Ting-Dong , Zhang Shi-Yin , Zhang Xue-Jie , Bi Zhao-Feng , Deng Chen-Xi , Li Cai-Yu , Yuan Quan , Zhang Jun , Zhang Tian-Ying , Wang Zhan-Xiang , Ge Sheng-Xiang , Xia Ning-Shao
Published: July 2020

Knowledge of the host immune response after natural SARS-CoV-2 infection is essential for informing directions of vaccination and epidemiological control strategies against COVID-19. In this study, thirty-four COVID-19 patients were enrolled with 244 serial blood specimens (38.1% after hospital discharge) collected to explore the chronological evolution of neutralizing (NAb), total (TAb), IgM, IgG and IgA antibody in parallel. IgG titers reached a peak later (approximately 35 days postonset) than those of Nab, Ab, IgM and IgA (20∼25 days postonset). After peaking, IgM levels declined with an estimated average half-life of 10.36 days, which was more rapid than those of IgA (51.25 days) and IgG (177.39 days). Based on these half-life data, we estimate that the median times for IgM, IgA and IgG to become seronegative are 4.59 (IQR 4.12-5.03), 7.78 (IQR 6.71-9.16) and 42.72 (IQR 33.75-47.96) months post disease onset. The relative contribution of IgM to NAb was higher than that of IgG (standardized β regression coefficient: 0.53 vs 0.48), so the rapid decline in NAb may be attributed to the rapid decay of IgM in acute phase. However, the relative contribution of IgG to NAb increased and that of IgM further decreased after 6 weeks postonset. It’s assumed that the decline rate of NAb might slow down to the same level as that of IgG over time. This study suggests that SARS-CoV-2 infection induces robust neutralizing and binding antibody responses in patients and that humoral immunity against SARS-CoV-2 acquired by infection may persist for a relatively long time.
Adjunctive Corticosteroids for COVID-19: A Retrospective Cohort Study
Authors: Tat Ooi Say , Parthasarathy Purnima , Yi Lin , D/O Nallakaruppan Valliammai , Jia Huey Shereen Ng , Choon Tan Teck , Serena Low , Terence Tang
Published: July 2020

Background

Coronavirus disease 2019 (COVID-19) is associated with severe pneumonia, respiratory failure and death. We aim to evaluate the efficacy of adjunctive corticosteroids in the management of COVID-19.

Methods

This is a retrospective cohort study of hospitalized adults (≥18 years) who were diagnosed with COVID-19 and were given treatment. Treatment included hydroxycholoroquine and lopinavir-ritonavir. Corticosteroids were included as adjunctive therapy in mid-April, 2020. We compared composite outcomes of clinical progression and invasive mechanical ventilation (MV) or death between group that received treatment only (Group A) versus group that received adjunctive corticosteroids (Group B). Entropy balancing was used to generate stabilized weight for covariates between treatment groups. Unweighted Kaplan-Meir curves, weighted and adjusted Cox regression analysis were used to estimate effect of adjunctive corticosteroids on composite outcomes. Subgroup analysis was performed on those with pneumonia.

Results

Of 1046 patients with COVID-19, 57 received treatment alone (Group A) and 35 received adjunctive corticosteroids in addition to treatment (Group B). Median day of illness at treatment initiation was 5 day. There were 44 patients with pneumonia; 68.9% of them were not requiring supplemental oxygen at treatment initiation. Overall, 17 (18.5%) of 92 patients had clinical progression including 13 (22.8%) of 57 patients in Group A versus 4 (11.4%) of 35 patients in Group B (p=0.172). Unweighted Kaplan-Meier estimates showed no significant difference in the proportion of patients who had clinical progression or invasive MV or death between the 2 treatment groups. However in those with pneumonia, there were lower proportions of patients in Group B with clinical progression (11.1%, 95% CI 0.0 - 22.2 versus 58.8%, 95% CI 27.3 - 76.7, log rank p<0.001); and invasive MV or death (11.3%, 95% CI 0.0 - 22.5 versus 41.2%, 95% CI 12.4. - 60.5, log rank p=0.016). In weighted and adjusted cox regression analysis, patients in Group B were less likely to have clinical progression, (adjusted HR [aHR] 0.08, 95% CI 0.01-0.99, p=0.049) but there was no statistical significant difference in risk of requiring invasive MV or death (aHR 0.22, 95%CI 0.02 - 2.54, p=0.22). In subgroup with pneumonia, patients in Group B were significantly at lower risk of clinical progression (aHR 0.15, 95% CI 0.06 - 0.39, p<0.001) and requiring invasive MV compared to Group A (aHR 0.30, 0.10-0.87, p=0.029).

Conclusions

Use of adjunctive corticosteroids is associated with lower risk of clinical progression and invasive MV or death, especially in those with pneumonia. Concurrent use of antivirals and corticosteroids should be considered in the management of COVID-19 related pneumonia.
Population genetic analysis of Indian SARS-CoV-2 isolates reveals a unique phylogenetic cluster
Authors: Das Dhruv , Akkipeddi V.S.S.N.R
Published: July 2020

The SARS-CoV-2 pandemic originated from Wuhan, China in December 2019 raised an alarming situation all over the globe. Sequencing of this novel virus provides an opportunity to evaluate the genetic polymorphism present in the viral population. Herein, we analysed 173 sequences isolated from Indian patients and performed SNP linkage, clustering and phylogenetic analysis to understand the local genetic diversity. We found that the SNP linkages that lead to the identification of some global clades, do not hold true for the local clade classification. In addition to the unique cluster, established by another Indian study, we identified a new cluster (I-20D) that encompasses 28% of the analysed sequences. This cluster is defined by two linked variations – C22444T and C28854T. A detailed study of such polymorphisms can be useful for drug and vaccine development.
Exploration of endogenous miRNA-200b/c activity and regulation through a functional dual fluorescence reporter
Authors: Gollavilli Paradesi , Parma Beatrice , Siddiqui Aarif , Yang Hai , Ramesh Vignesh , Napoli Francesca , Schwab Annemarie , Natesan Ramakrishnan , Asangani Irfan Ahmed , Brabletz Thomas , Pilarsky Christian , Ceppi Paolo
Published: July 2020

Since their discovery, microRNAs (miRNA)s have been widely studied in almost every aspect of biology and medicine, leading to the identification of important gene regulation circuits and cellular mechanisms. However, investigations are generally focused on the analysis of their downstream targets and biological functions in overexpression and knockdown approaches, while miRNAs endogenous levels and activity remain poorly understood. Here, we used the cellular plasticity-regulating process of epithelial-to-mesenchymal transition (EMT) as a model to show the efficacy of a fluorescent sensor to separate cells with distinct EMT signatures, based on miR-200b/c activity. The system was further combined with a CRISPR-Cas9 screening platform to unbiasedly identify miR-200b/c upstream regulating genes. The sensor allows to infer miRNAs fundamental biological properties, as profiling of sorted cells indicated miR-200b/c as a molecular switch between EMT differentiation and proliferation, and suggested a role for metabolic enzymes in miR-200/EMT regulation. Analysis of miRNAs’ endogenous levels and activity could lead to a better understanding of their biological role in physiology and disease.
Probing the dynamic structure-function and structure-free energy relationships of the corona virus main protease with Biodynamics theory
Authors: Wan Hongbin , Aravamuthan Vibhas , Pearlstein Robert A.
Published: July 2020

The SARS-CoV-2 Main protease (Mpro) is of major interest as an anti-viral drug target. Structure-based virtual screening efforts, fueled by a growing list of apo and inhibitor-bound SARS-CoV/CoV-2 Mprocrystal structures, are underway in many labs. However, little is known about the dynamic enzyme mechanism, which is needed to inform both structure-based design and assay development. Here, we apply Biodynamics theory to characterize the structural dynamics of substrate-induced Mproactivation, and explore the implications thereof for efficacious inhibition under non-equilibrium conditions. The catalytic cycle (including tetrahedral intermediate formation and hydrolysis) is governed byconcerteddynamic structural rearrangements of domain 3 and the m-shaped loop (residues 132-147) on which Cys145 (comprising the thiolate nucleophile and one-half of the oxyanion hole) and Gly143 reside (comprising the other half of the oxyanion hole). In particular:

Domain 3 undergoes dynamic rigid-body rotations about the domain 2-3 linker, alternately visiting two conformational states (denoted as).

The Gly143-containing crest of the m-shaped loop (denoted as crest B) undergoes up and down translations in concert with the domain 3 rotations (denoted as, whereas the Cys145-containing crest (denoted as crest A) remains statically in the up position. The crest B translations are driven by conformational transitions within the rising leg of the loop (Lys137-Asn142).

We propose that substrates associate to thestate, which promotes thestate, dimerization (denoted as-substrate), and catalysis. The structure resets to the dynamic monomeric form upon dissociation of the N-terminal product. We describe the energetics of the aforementioned state transitions, and address the implications of our proposed mechanism for efficacious Mproinhibition under native-like conditions.
Unique contributions of sensory discrimination and gamma synchronization deficits to cognitive, clinical, and psychosocial functional impairments in schizophrenia
Authors: Koshiyama Daisuke , Miyakoshi Makoto , Thomas Michael L. , Joshi Yash B. , Molina Juan L. , Tanaka-Koshiyama Kumiko , Sprock Joyce , Braff David L. , Swerdlow Neal R. , Light Gregory A.
Published: July 2020

Background

Schizophrenia patients show widespread deficits in neurocognitive, clinical and psychosocial functioning. Mismatch negativity (MMN) and gamma-band auditory steady-state response (ASSR) are robust biomarkers for domains of neuropsychiatric disorders that are impaired in schizophrenia patients and are separately associated with cognitive dysfunction, negative symptom severity and psychosocial disability. Although these measures of early auditory information processing are conceptually linked, it is unclear, whether these measures are redundant or account for unique variance in important outcome measures. In this study, we aimed to determine whether MMN and gamma-band ASSR are associated with cognitive, clinical, and functional variables and, if so, whether they account for shared vs. non-shared variance in those important domains.

Methods

Multiple regression analyses with MMN, gamma-band ASSR and clinical measures were performed in large cohorts of schizophrenia outpatients (N=428) and healthy comparison subjects (N=283).

Results

Reduced MMN (d= 0.67), gamma-band ASSR (d= –0.40), and lower cognitive function were confirmed in schizophrenia patients compared to healthy comparison subjects. Regression analyses revealed that both MMN and gamma-band ASSR have significant unique associations with tasks measuring of working memory, and daily functioning in schizophrenia patients.

Conclusion

These findings suggest that MMN and ASSR measures are non-redundant and complementary measures. Studies are needed to clarify the neural substrates of MMN and gamma-band ASSR in order to improve our understanding of pathophysiology of schizophrenia and accelerate their use in the development of novel therapeutic interventions.