bluuebunny/crossref_metadata_2025 huggingface dataset:
Population, Virulence, and Mycotoxin Profile ofFusariumspp. Associated With Basal Rot ofAlliumspp. in Vietnam
Authors: Le Dung , Ameye Maarten , De Boevre Marthe , De Saeger Sarah , Audenaert Kris , Haesaert Geert
Published: December 2020

Fusarium basal rot (FBR) is particularly problematic to Allium producers worldwide. In Vietnam, information on the profile of FBR is scarce, even though the presence of Fusarium spp. in Allium plants has long been recorded. In this study, a total of 180 isolates of Fusarium spp. were recovered from Allium bulbs/plants showing symptoms of FBR in 34 commercial Allium fields around Da Lat, Lam Dong, Vietnam. These isolates were identified to the species level by sequencing the internal transcribed spacer region and the translation elongation factor 1α gene. F. oxysporum was most prevalent (81%) in samples from all locations and Allium varieties, followed by F. solani (15%) and F. proliferatum (4%), which were only found in onion (Allium cepa L.). Pathogenicity tests on onion seedlings (56 isolates) and mini bulbs (10 isolates) indicated that onion can be infected by all of these species but virulence varied greatly between isolates. Moreover, isolates that were virulent on seedlings were sometimes not virulent on bulbs and vice versa, which points to a specialization of isolates for the host phenology. Mycotoxin analyses showed that the highest amounts of beauvericin were detected in seedlings and bulbs infected by F. oxysporum, whereas F. proliferatum was mainly responsible for the presence of fumonisin B1in bulbs, suggesting a natural occurrence of beauvericin and fumonisin B1in onions infected by these pathogens.
Subcutaneous Air Around Receiver-Stimulator Causing Open-Circuit Failures: An Uncommon But Readily Treatable Condition Related to CPAP Use After Cochlear Implant Surgery
Authors: Macielak Robert J. , Adkins Weston J. , Barnes Jason H. , Saoji Aniket A. , Gruenwald Jill M. , Bertsch Natasha J. , Carlson Matthew L.
Published: December 2020

Objective:

To raise awareness of a unique complication associated with continuous positive airway pressure (CPAP) use after cochlear implantation to improve early detection, prevent unnecessary testing, and facilitate treatment.

Study Design:

Case series.

Setting:

Tertiary referral center.

Subjects:

Patients who developed subcutaneous air around the receiver-stimulator device and the associated ground electrode in the setting of CPAP usage, which resulted in open-circuit electrode failures.

Main Outcome Measures:

Clinical course and intervention.

Results:

Two patients were identified that fit this criterion. Both patients were noted to have poor implant performance secondary to high or open impedances and concomitant emphysema surrounding the cochlear implant receiver-stimulator. Manual massage offered transient improvement, but programming changes ultimately led to improved sound quality and resolution of impedance anomalies in both cases.

Conclusions:

Subcutaneous air collection surrounding the cochlear implant receiver-stimulator in the setting of CPAP use is an uncommon but clinically relevant complication that can be recognized by characteristic physical examination findings and impedance changes. Early and accurate recognition of this event can prevent unnecessary testing and facilitate early effective treatment.
Auditory Performance in Recovered SARS-COV-2 Patients
Authors: Dror Amiel A. , Kassis-Karayanni Najla , Oved Adi , Daoud Amani , Eisenbach Netanel , Mizrachi Matti , Rayan Doaa , Francis Shawky , Layous Eli , Gutkovich Yoni Evgeni , Taiber Shahar , Srouji Samer , Chordekar Shai , Goldenstein Sonia , Ziv Yael , Ronen Ohad , Gruber Maayan , Avraham Karen B. , Sela Eyal
Published: December 2020

Objective:

While COVID-19 symptoms impact rhinology (anosmia) and laryngology (airways), two major disciplines of the otolaryngology armamentarium, the virus has seemed to spare the auditory system. A recent study, however, reported changes in otoacoustic emission (OAE) signals measured in SARS-COV-2 positive patients. We sought to assess the effect of COVID-19 infection on auditory performance in a cohort of recovered SARS-COV-2 patients and controls. To avoid a potential bias of previous audiological dysfunction not related to SARS-COV-2 infection, the study encompasses patients with normal auditory history. We hypothesized that if SARS-COV-2 infection predisposes to hearing loss, we would observe subtle and early audiometric deficits in our cohort in the form of subclinical auditory changes.

Study Design:

Cross-sectional study.

Setting:

Tertiary referral center.

Patients:

The Institutional Review Board approved the study and we recruited participants who had been positive for SARS-COV-2 infection, according to an Reverse Transcription Polymerase Chain Reaction (RT-PCR) test on two nasopharyngeal swabs. The patients included in this study were asymptomatic for the SARS-COV-2 infection and were evaluated following recovery, confirmed by repeated swab testing. The control group comprised healthy individuals matched for age and sex, and with a normal auditory and otologic history.

Intervention(s):

The eligibility to participate in this study included a normal audiogram, no previous auditory symptoms, normal otoscopy examination with an intact tympanic membrane, and bilateral tympanometry type A. None of our volunteers reported any new auditory symptoms following SARS-COV-2 infection. Ototacoustic emissions (OAE) and auditory brainstem response (ABR) measurements were used to evaluate the auditory function.

Main Outcome Measure(s):

OAE and ABR measurements.

Results:

We have found no significant differences between recovered asymptomatic SARS-COV-2 patients and controls in any of transitory evoked otoacoustic emission (TEOAE), distortion product otoacoustic emissions (DPOAE), or ABR responses.

Conclusions:

There is no cochlear dysfunction represented by ABR, TEOAE, and DPOAE responses in recovered COVID-19 asymptomatic patients. Retrocochlear function was also preserved as evident by the ABR responses. A long-term evaluation of a larger cohort of SARS-COV-2 patients will help to identify a possible contribution of SARS-COV-2 infection to recently published anecdotal auditory symptoms associated with COVID-19.
The Effect of Helicobacter pylori on the Presentation and Clinical Course of Coronavirus Disease 2019 Infection
Authors: Balamtekin Necati , Artuk Cumhur , Arslan Melike , Gülşen Mustafa
Published: December 2020

Objectives:

Novel coronavirus 2019 (corona virus disease 2019 [COVID‐19]) binds angiotensin‐converting enzyme‐2 (ACE‐2) receptors to enter the cell. These receptors are widely expressed in the intestine, and COVID‐19 may cause gastrointestinal symptoms via these receptors during the course of the disease. Helicobacter pylori is known to increase the expression of ACE‐2 receptors in the gastrointestinal tract. The aim of this study was to investigate the effects of H pylori on the presentation and clinical course of COVID‐19 infections.

Methods:

This study was carried out from June 1 to July 20, 2020. Patients diagnosed with COVID‐19 infections by PCR tests were included in the study. Antigen screening tests were performed on stool samples to determine the presence of H pylori. All patients were evaluated for manifestations of COVID‐19 infection, severity of the course, hospitalized days because of the virus and outcome of the disease process.

Results:

Of 108 COVID‐19 positive patients evaluated, 31 with a mean age of 49.54 ± 17.94 years were H pylori‐positive (8 girls [25.8%]) and 77 with a mean age of 47.85 ± 20.51 years; (31 girls [40.3%]) were H pylori‐negative. Abdominal pain (19.4% vs 2.6%) and diarrhea (32.3% vs 9.1%) were significantly higher in patients with H pylori than those without (P = 0.007 and P = 0.006, respectively). There was no statistically significant difference between H pylori positivity and the number of hospitalized days, the severity of the course of COVID‐19 infection, or the outcome of the disease (P > 0.05).

Conclusion:

Our results revealed that the findings of abdominal pain and diarrhea strongly correlated with the presence of H pylori in COVID‐19 patients.
The Role of Guilt and Shame in Psychosocial Functioning in a Sample of Women With Borderline Personality Disorder
Authors: Cameron Amy Y. , Benz Madeline , Reed Kathleen Palm
Published: December 2020

Individuals diagnosed with borderline personality disorder (BPD) experience significant and pervasive impairment in interpersonal, social, and vocational functioning, and accumulating evidence suggests that impairments in functioning often persist despite significant decreases in symptom severity. Previous research indicates that shame-proneness and guilt-proneness are associated with symptoms of BPD that can affect functioning (such as aggression toward others), but very few studies have examined the impact of shame-proneness and guilt-proneness on validated measures of psychosocial functioning. Forty women with BPD completed measures of shame-proneness and guilt-proneness, psychosocial functioning, and BPD symptom severity. Results from multiple regression analyses indicate that women with BPD who tend to experience higher levels of shame-proneness and lower levels of guilt-proneness report poor performance in school and work settings and in interpersonal relationships. Strengths of the study include the use of a validated measure of functioning as the primary outcome. Limitations and future directions are discussed.
Examining the Link Between Intolerance of Uncertainty and Positive and Negative Urgency in Veterans With Comorbid Posttraumatic Stress Disorder and Substance Use Disorders
Authors: McGuire Adam P. , Hayden Candice L. , Zambrano-Vazquez Laura , Connolly Kevin M.
Published: December 2020

Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are highly comorbid among the veteran population. Impulsivity, particularly negative and positive urgency, are prevalent within this dual-diagnosis population and associated with negative outcomes. One possible correlate of negative/positive urgency is intolerance of uncertainty (IU). IU is associated with exacerbated PTSD symptom severity and increased risk for substance use. However, few studies have examined the link between IU and negative/positive urgency in dual-diagnosis populations. This study aimed to examine whether there was a significant association between trait IU and baseline negative and positive urgency in veterans seeking treatment for both PTSD and SUD. In a sample of 114 veterans from a 6-week residential treatment program, IU was significantly associated with higher negative and positive urgency. Further research is warranted to extend these findings and examine whether IU plays an important role in negative/positive urgency for dual-diagnosis populations.
Clinician Engagement in Quality: A Literature Review
Authors: Dickinson Marie , Duffield Christine , Bichel-Findlay Jen , Travaglia Joanne
Published: December 2020

Background and Objectives:

Defining quality in the health care context has proven difficult, with many organizations not able to clearly articulate their use of this term in a manner that is easily understood by their clinical staff. This review seeks to investigate the literature to explore clinician engagement in quality including where engagement has been problematic, and if the reasons for this have been identified.

Methods:

An integrative review of the literature was undertaken to determine whether evidence within the literature supports a hypothesis that there is a lack of understanding of and engagement in quality at an organizational level by health professionals. A search of the literature was conducted using EBSCO Academic Complete, CINAHL, and MEDLINE databases.

Results:

This article identified 18 studies where the understanding of quality by clinicians and their level of engagement with the process are investigated. We found that there has been no comprehensive study that explores the development of an agreed-upon definition and measurement of quality or clinician understanding and engagement in quality. The studies conducted have been small and discipline-specific.

Conclusion:

There is a growing body of evidence indicating that clinical and nonclinical staff interpret the meaning of quality and quality improvement differently. Quality and quality improvement are interpreted in relation to the clinician's individual work, professional, and learning and development experience. The literature suggests that clinician interpretation is influenced in part by their own personal beliefs and values, in addition to their interpretation of their individual work/professional responsibilities.
The Stress Concentration and Biomechanical Properties of the Intra-oral Distractors and the Extra-oral Distractors Used in Treatment of Post Ankylosis Facial Asymmetric Patients: A Finite Element Analysis Study
Authors: Elhadidi Yasser Nabil , Askar Mohamed Gamal , El Sayed Abdulmotakaber Galal Abdullatif
Published: December 2020

Assessment of stress and micromotions using finite element analysis along both the intraoral and the extraoral distractors devices used in the mandibular distraction of post temporomandibular joint ankylosis deformed mandible patients. The process of finite element analysis was carried out to assess distraction models. The first model was an extraoral mandibular distraction model and the second model was an intraoral mandibular distraction model. To analyze the stress state, 2 vertical loads were applied on the defective and normal side respectively by a 3D finite element ball model. The intraoral system observed lower stress (4.5 MPa) in the mandibular bone compared to the extra-oral system (11.5 MPa). The results revealed that the intraoral system observed higher stress on the distractor fixing points (392.21 MPa) compared to the extra-oral fixing points (12.62 MPa). The results revealed that the extra-oral system reflected higher displacement on the bone surrounding the screws of about 3720 μm compared to the intraoral system 1414.6 μm. Internal devices give better shielding to the bone and induce fewer stresses over the mandibular, so it is more advisable to be used. The external devices permit greater distraction length because the pins and the distractor main body are subjected to fewer stresses.
Cleft and COVID-19 Pandemic: Controversial Aspects of Social Distancing
Authors: Nabavizadeh Sara Sadat , Nadjmi Nasser , Vardanjani Hossein Molavi
Published: December 2020

In the meantime, as COVID-19 has gone pandemic, social distancing has become inevitable; therefore, most in-person visits have been canceled to minimize the spread of the disease. This will greatly impact cleft palate patients as it will limit their chance to receive timely care and have persistent follow-up, and that could in turn delay its management so significantly that it could cause much more considerable complications. To mitigate the issue, it seems necessary to start integrating modern-day technologies into the everyday practice of physicians and to benefit from the opportunities it provides. Much of medical decision making is cognitive, and telemedicine can provide easy access to specialists who are not immediately available. With wide internet access, this task is more than feasible. Telemedicine and other modern facilities are very promising platforms that could fill the gap that has been made by social distancing. We tried to address some of these issues as well as give recommendations for possible solutions to each of them.
Electrophysiological and anatomical factors determine arrhythmic risk in acute myocardial ischaemia and its modulation by sodium current availability
Authors: Martinez-Navarro Hector , Zhou Xin , Bueno-Orovio Alfonso , Rodriguez Blanca
Published: December 2020

Acute myocardial ischaemia caused by coronary artery disease is one of the main causes of sudden cardiac death. Even though sodium current blockers are used as anti-arrhythmic drugs, decreased sodium current availability, also caused by mutations, has been shown to increase arrhythmic risk in ischaemic patients. The mechanisms are still unclear. Our goal is to exploit perfect control and data transparency of over 300 high-performance computing simulations to investigate arrhythmia mechanisms in acute myocardial ischaemia with variable sodium current availability. The human anatomically based torso-biventricular electrophysiological model used includes representation of realistic ventricular anatomy and fibre architecture, as well as ionic to electrocardiographic properties. Simulations show that reduced sodium current availability increased arrhythmic risk in acute regional ischaemia due to both electrophysiological (increased dispersion of refractoriness across the ischaemic border zone) and anatomical factors (conduction block from the thin right ventricle to thick left ventricle). The asymmetric ventricular anatomy caused high arrhythmic risk specifically for ectopic stimuli originating from the right ventricle and ventricular base. Increased sodium current availability was ineffective in reducing arrhythmic risk for septo-basal ectopic excitation. Human-based multiscale modelling and simulations reveal key electrophysiological and anatomical factors determining arrhythmic risk in acute ischaemia with variable sodium current availability.
Haemodynamic flow conditions at the initiation of high-shear platelet aggregation: a combined
in vitro
and cellular
in silico
study
Authors: van Rooij B. J. M. , Závodszky G. , Hoekstra A. G. , Ku D. N.
Published: December 2020

The influence of the flow environment on platelet aggregation is not fully understood in high-shear thrombosis. The objective of this study is to investigate the role of a high shear rate in initial platelet aggregation. The haemodynamic conditions in a microfluidic device are studied using cell-based blood flow simulations. The results are compared with
in vitro
platelet aggregation experiments performed with porcine whole blood (WB) and platelet-rich-plasma (PRP). We studied whether the cell-depleted layer in combination with high shear and high platelet flux can account for the distribution of platelet aggregates. High platelet fluxes at the wall were found
in silico
. In WB, the platelet flux was about twice as high as in PRP. Additionally, initial platelet aggregation and occlusion were observed
in vitro
in the stenotic region. In PRP, the position of the occlusive thrombus was located more downstream than in WB. Furthermore, the shear rates and stresses in cell-based and continuum simulations were studied. We found that a continuum simulation is a good approximation for PRP. For WB, it cannot predict the correct values near the wall.
A porous circulation model of the human brain for
in silico
clinical trials in ischaemic stroke
Authors: Józsa T. I. , Padmos R. M. , Samuels N. , El-Bouri W. K. , Hoekstra A. G. , Payne S. J.
Published: December 2020

The advancement of ischaemic stroke treatment relies on resource-intensive experiments and clinical trials. In order to improve ischaemic stroke treatments, such as thrombolysis and thrombectomy, we target the development of computational tools for
in silico
trials which can partially replace these animal and human experiments with fast simulations. This study proposes a model that will serve as part of a predictive unit within an
in silico
clinical trial estimating patient outcome as a function of treatment. In particular, the present work aims at the development and evaluation of an organ-scale microcirculation model of the human brain for perfusion prediction. The model relies on a three-compartment porous continuum approach. Firstly, a fast and robust method is established to compute the anisotropic permeability tensors representing arterioles and venules. Secondly, vessel encoded arterial spin labelling magnetic resonance imaging and clustering are employed to create an anatomically accurate mapping between the microcirculation and large arteries by identifying superficial perfusion territories. Thirdly, the parameter space of the problem is reduced by analysing the governing equations and experimental data. Fourthly, a parameter optimization is conducted. Finally, simulations are performed with the tuned model to obtain perfusion maps corresponding to an open and an occluded (ischaemic stroke) scenario. The perfusion map in the occluded vessel scenario shows promising qualitative agreement with computed tomography images of a patient with ischaemic stroke caused by large vessel occlusion. The results highlight that in the case of vessel occlusion (i) identifying perfusion territories is essential to capture the location and extent of underperfused regions and (ii) anisotropic permeability tensors are required to give quantitatively realistic estimation of perfusion change. In the future, the model will be thoroughly validated against experiments.
Analysis of mechanotransduction dynamics during combined mechanical stimulation and modulation of the extracellular-regulated kinase cascade uncovers hidden information within the signalling noise
Authors: Ascolani Gianluca , Skerry Timothy M. , Lacroix Damien , Dall'Ara Enrico , Shuaib Aban
Published: December 2020

Osteoporosis is a bone disease characterized by brittle bone and increased fracture incidence. With ageing societies worldwide, the disease presents a high burden on health systems. Furthermore, there are limited treatments for osteoporosis with just two anabolic pharmacological agents approved by the US Food and Drug Administration. Healthy bones are believed to be maintained via an intricate relationship between dual biochemical and mechanical (bio-mechanical) stimulations. It is widely considered that osteoporosis emerges as a result of disturbances to said relationship. The mechanotransduction process is key to this balance, and disruption of its dynamics in bone cells plays a role in osteoporosis development. Nonetheless, the exact details and mechanisms that drive and secure the health of bones are still elusive at the cellular and molecular scales. This study examined the dual modulation of mechanical stimulation and mechanotransduction activation dynamics in an osteoblast (OB). The aim was to find patterns of mechanotransduction dynamics demonstrating a significant change that can be mapped to alterations in the OB responses, specifically at the level of gene expression and osteogenic markers such as alkaline phosphatase. This was achieved using a three-dimensional hybrid multiscale computational model simulating mechanotransduction in the OB and its interaction with the extracellular matrix, combined with a numerical analytical technique. The model and the analysis method predict that within the noise of mechanotransduction, owing to modulation of the bio-mechanical stimulus and consequent gene expression, there are unique events that provide signatures for a shift in the system's dynamics. Furthermore, the study uncovered molecular interactions that can be potential drug targets.
The burden of active infection and anti-SARS-CoV-2 IgG antibodies in the general population: Results from a statewide survey in Karnataka, India
Authors: Babu Giridhara R , Sundaresan Rajesh , Athreya Siva , Akhtar Jawaid , Pandey Pankaj Kumar , Maroor Parimala S , Padma MR , Lalitha R , Shariff Mohammed , Krishnappa Lalitha , Manjunath CN , Sudarshan MK , Gururaj G , Ranganath TS , Kumar Vasanth , Banandur Pradeep , Deepa R , Shiju Shilpa , Lobo Eunice , Satapathy Asish , Alahari Lokesh , Prameela  , Vinitha T , Desai Anita , Ravi V
Published: December 2020

Background

Globally, the routinely used case-based reporting and IgG serosurveys underestimate the actual prevalence of COVID-19. Simultaneous estimation of IgG antibodies and active SARS-CoV-2 markers can provide a more accurate estimation.

Methods

A cross-sectional survey of 16416 people covering all risk groups was done between 3-16 September 2020 using the state of Karnataka’s infrastructure of 290 hospitals across all 30 districts. All participants were subjected to simultaneous detection of SARS-CoV-2 IgG using a commercial ELISA kit, SARS-CoV-2 antigen using a rapid antigen detection test (RAT), and reverse transcription-polymerase chain reaction (RT-PCR) for RNA detection. Maximum-likelihood estimation was used for joint estimation of the adjusted IgG, active, and total prevalence, while multinomial regression identified predictors.

Findings

The overall adjusted prevalence of COVID-19 in Karnataka was 27 ·3% (95% CI: 25 ·7-28 ·9), including IgG 16 ·4% (95% CI: 15 ·1 - 17 ·7) and active infection 12 ·7% (95% CI: 11 ·5-13 ·9). The case-to-infection ratio was 1:40, and the infection fatality rate was 0 ·05%. Influenza-like symptoms or contact with a COVID-19 positive patient are good predictors of active infection. The RAT kits had higher sensitivity (68%) in symptomatic participants compared to 47% in asymptomatic.

Interpretation

This is the first comprehensive survey providing accurate estimates of the COVID-19 burden anywhere in the world. Further, our findings provide a reasonable approximation of population immunity threshold levels. Using the RAT kits and following the syndromic approach can be useful in screening and monitoring COVID-19. Leveraging existing surveillance platforms, coupled with appropriate methods and sampling framework, renders our model replicable in other settings.
A Simplified Bayesian Analysis Method for Vaccine Efficacy
Authors: Graziani Carlo
Published: December 2020

We describe a simplified Bayesian analysis of vaccine trial data, in which a reparametrization of the Poisson likelihood leads to a factorization in which the protective vaccine efficacyVESand the nuisance parameter appear in different factors. As a consequence the posterior density acquires a factorized form, and marginalization over the nuisance parameter is trivial. Estimates ofVESaccordingly become a matter of simple manipulations of one-dimensional posterior probability densities. We demonstrate the method using the publically-released data on the efficacy of three vaccines agains SARS-CoV-2: the final Phase III data from the Pfizer/BioNTech and Moderna mRNA vaccines and the interim data released for the Sputnik V adenovirus-based vaccine.
COVID-19 Rapid Diagnostic test results and their associations with certain factors among the residents of Balochistan
Authors: Larik Ehsan , Arif Muhammad , Saeed Abid , Baig Mirza Amir , Hussain Zakir , Chaudhary Ambreen , Baig Zeeshan Iqbal , Bugti Zubair , Inayat Jan , Muhammad Khair , Abdullah Muhammad , Ahmed Zubair , Qurat-ul-ain  , Kakar Aftab , Sheik Nasir
Published: December 2020

Background

This paper analyses any possible association of various factors like gender, last COVID-19 PCR test results, BCG Vaccination, Seasonal Flu vaccination, Occupation and confirmed case contact history with COVID-19 RDT results of the participants. COVID-19 will soon become endemic in Pakistan, the government should adopt COVID-19 RDT kits for trace, test and quarantine activities.

Methodology

Considering the availability of COVI-19 rapid diagnostic kits, 596 individuals all previously COVID-19 PCR tested were made part of this cross sectional study. Simple random sampling was used for the selection of study participants. The whole study was conducted during September and October 2020.

Results

The major findings of this study is clearly showing that the Positive Likely hood ratio of the COVID-19 RDT Kits (LR+) is well above 1; similarly the Negative Likely hood ratio is approaching 0.On the other hand the Sensitivity and Specificity 80% and 74% respectively. Similarly study found statistically significant association was between RDT out comes and Last PCR Test status, Occupation and Contact with COVID-19 positive individuals. While other variables like Gender, BCG Vaccination and history of seasonal flu vaccinations were found to have no significant associations with COVID-19 RDT Kit out comes.

Conclusion

Being the first study of its kind in Pakistan the major findings of this study are almost in line with the set hypothesis and objectives of this study and based on study findings it will be of high value to use COVID-19 RDT kits during mass screening especially during Test, Trace and Quarantine activities.
Why the SARS-CoV-2 antibody test results may be misleading: insights from a longitudinal analysis of COVID-19
Authors: Taubel Jorg , Cole Samuel Thomas , Spencer Christopher S. , Freier Anne , Camilleri Dorothée , Lorch Ulrike
Published: December 2020

To estimate the effectiveness of vaccines in development, a robust mechanism is required to understand immunity, risks of reinfection and measure the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and how this may change over time. This study is a longitudinal analysis of COVID-19 infection rates using PCR, membrane immunoassay and chemiluminescent microparticle immunoassay (CMIA) diagnostic tests. Our data confirm that antibody levels wane in the three months after symptom onset. Comparison of the three methods used suggests that quantitative CMIA testing may exaggerate numbers of COVID-19 negative individuals.
Sex differences in genetic and environmental influences on frailty and its relation to body mass index and education
Authors: Mak Jonathan K. L. , Reynolds Chandra A. , Hägg Sara , Li Xia , Ericsson Malin , Pedersen Nancy L. , Jylhävä Juulia , Kuja-Halkola Ralf
Published: December 2020

Background

Frailty is a multifactorial expression of aging influenced by numerous genetic and environmental factors. However, sex differences in how these factors may affect frailty, and the gene-environment interplay among frailty and two of its well-established risk factors, unhealthy body mass index (BMI) and low education, are less clear.

Methods

In a large sample of 42,994 Swedish twins aged 41–99 years, we used structural equation models to estimate the genetic (heritability) and environmental sources of variance in frailty, defined as the Rockwood frailty index (FI), separately in men and women. We also estimated the genetic and environmental contributions to the associations between FI and BMI, and FI and education. Moderation models were fitted to test for gene-environment interaction by levels of BMI and education.

Results

Genetic and individual-specific environmental factors contributed approximately equally to the FI variance. The heritability of FI was slightly higher in women (52%) than in men (45%), yet we found only weak-to-no indication of different sources of genetic variance influencing frailty in men and women. A small-to-moderate genetic overlap between FI and BMI, and a perfect negative correlation of the environmental factors common to twins in a pair between FI and education were observed. Additionally, the heritability of FI was greater at both low and high BMI levels, with similar patterns of moderation in both sexes.

Conclusions

Individual differences in frailty are equally influenced by genetic and individual-specific environmental factors, and different mechanisms seem to underlie the association of frailty with BMI and education.
Geographic variation in work disability burden: Identifying hotspots, coldspots, and associated sociodemographic factors
Authors: Lane Tyler J , Collie Alex
Published: December 2020

Objectives

To identify geographic hotspots and coldspots of work disability burden and associated sociodemographic factors in Australia.

Methods

Using Australian workers’ compensation and census data, we calculated weeks of compensated time off work per 1,000 labour force at Statistical Area Level 4, an indicator of work disability burden. Records included all claims with at least one day of compensated time off work lodged between 2010 and 2015. Work disability burden was z-transformed by state and mapped across Australia. Statistical Areas ≥ 1.5 standard deviations from the state/territory mean were considered hotspots and coldspots. We tested several sociodemographic factors as predictors of work disability burden.

Results

Work disability burden hotspots were concentrated in lower socioeconomic suburbs and exurbs of state capitals, plus several regional areas. Coldspots were primarily in wealthy central urban and suburban areas. Factors associated with greater work disability burden include socioeconomic disadvantage, rurality, lower labour force participation, higher unemployment, and more people with core activity limitations, aged 65+ years, and aged 65+ but fewer foreign-born.

Conclusions

Work disability burden is unequally distributed across Australia and strongly influenced by sociodemographic factors. The findings can guide more efficient allocation of resources for primary and secondary work disability prevention and rehabilitation.
Artificial intelligence-enabled analysis of UK and US public attitudes on Facebook and Twitter towards COVID-19 vaccinations
Authors: Hussain Amir , Tahir Ahsen , Hussain Zain , Sheikh Zakariya , Gogate Mandar , Dashtipour Kia , Ali Azhar , Sheikh Aziz
Published: December 2020

Background

Global efforts towards the development and deployment of a vaccine for SARS-CoV-2 are rapidly advancing. We developed and applied an artificial-intelligence (AI)-based approach to analyse social-media public sentiment in the UK and the US towards COVID-19 vaccinations, to understand public attitude and identify topics of concern.

Methods

Over 300,000 social-media posts related to COVID-19 vaccinations were extracted, including 23,571 Facebook-posts from the UK and 144,864 from the US, along with 40,268 tweets from the UK and 98,385 from the US respectively, from 1st March - 22nd November 2020. We used natural language processing and deep learning based techniques to predict average sentiments, sentiment trends and topics of discussion. These were analysed longitudinally and geo-spatially, and a manual reading of randomly selected posts around points of interest helped identify underlying themes and validated insights from the analysis.

Results

We found overall averaged positive, negative and neutral sentiment in the UK to be 58%, 22% and 17%, compared to 56%, 24% and 18% in the US, respectively. Public optimism over vaccine development, effectiveness and trials as well as concerns over safety, economic viability and corporation control were identified. We compared our findings to national surveys in both countries and found them to correlate broadly.

Conclusions

AI-enabled social-media analysis should be considered for adoption by institutions and governments, alongside surveys and other conventional methods of assessing public attitude. This could enable real-time assessment, at scale, of public confidence and trust in COVID-19 vaccinations, help address concerns of vaccine-sceptics and develop more effective policies and communication strategies to maximise uptake.
Characterizing the Dynamic of COVID-19 with a New Epidemic Model: Susceptible-Exposed-Symptomatic-Asymptomatic-Active-Removed
Authors: Yi Grace Y , Hu Pingbo , He Wenqing
Published: December 2020

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread stealthily and presented a tremendous threat to the public. It is important to investigate the transmission dynamic of COVID-19 to help understand the impact of the disease on public health and economy. While a number of epidemic models have been available to study infectious diseases, they are in-adequate to describe the dynamic of COVID-19. In this paper, we develop a new epidemic model which utilizes a set of ordinary differential equations with unknown parameters to delineate the transmission process of COVID-19. Different from the traditional epidemic models, this model accounts for asymptomatic infections as well the lag between symptoms onset and the confirmation date of infection. We describe an estimation procedure for the unknown parameters in the proposed model by adapting the iterated filter-ensemble adjustment Kalman filter (IF-EAKF) algorithm to the reported number of confirmed cases. To assess the performance of our proposed model, we examine COVID-19 data in Quebec for the period of April 2, 2020 to May 10, 2020 and carry out sensitivity studies under a variety of assumptions. To reflect the transmission potential of an infected case, we derive the basic reproduction number from the proposed model. The estimated basic reproduction number suggests that the pandemic situation in Quebec for the period of April 2, 2020 to May 10, 2020 is not under control.
SARS-CoV-2 Viral Load in Saliva Rises Gradually and to Moderate Levels in Some Humans
Authors: Winnett Alexander , Cooper Matthew M. , Shelby Natasha , Romano Anna E. , Reyes Jessica A. , Ji Jenny , Porter Michael K. , Savela Emily S. , Barlow Jacob T. , Akana Reid , Tognazzini Colten , Feaster Matthew , Goh Ying-Ying , Ismagilov Rustem F.
Published: December 2020

Transmission of SARS-CoV-2 in community settings often occurs before symptom onset, therefore testing strategies that can reliably detect people in the early phase of infection are urgently needed. Early detection of SARS-CoV-2 infection is especially critical to protect vulnerable populations who require frequent interactions with caretakers. Rapid COVID-19 tests have been proposed as an attractive strategy for surveillance, however a limitation of most rapid tests is their low sensitivity. Low-sensitivity tests are comparable to high sensitivity tests in detecting early infections when two assumptions are met: (1) viral load rises quickly (within hours) after infection and (2) viral load reaches and sustains high levels (>105– 106 RNA copies/mL). However, there are no human data testing these assumptions. In this study, we document a case of presymptomatic household transmission from a healthy young adult to a sibling and a parent. Participants prospectively provided twice-daily saliva samples. Samples were analyzed by RT-qPCR and RT-ddPCR and we measured the complete viral load profiles throughout the course of infection of the sibling and parent. This study provides evidence that in at least some human cases of SARS-CoV-2, viral load rises slowly (over days, not hours) and not to such high levels to be detectable reliably by any low-sensitivity test. Additional viral load profiles from different samples types across a broad demographic must be obtained to describe the early phase of infection and determine which testing strategies will be most effective for identifying SARS-CoV-2 infection before transmission can occur.

One sentence summary

In some human infections, SARS-CoV-2 viral load rises slowly (over days) and remains near the limit of detection of rapid, low-sensitivity tests.
Through The Back Door: Expiratory Accumulation Of SARS-Cov-2 In The Olfactory Mucosa As Mechanism For CNS Penetration
Authors: Pipolo Carlotta , Bulfamante Antonio Mario , Schillaci Andrea , Banchetti Jacopo , Castellani Luca , Saibene Alberto Maria , Felisati Giovanni , Quadrio Maurizio
Published: December 2020

Introduction

SARS-CoV-2 is a respiratory virus supposed to enter the organism through aerosol or fomite transmission to the nose, eyes and oropharynx. It is responsible for various clinical symptoms, including hyposmia and other neurological ones. Current literature suggests the olfactory mucosa as a port of entry to the CNS, but how the virus reaches the olfactory groove is still unknown. Because the first neurological symptoms of invasion (hyposmia) do not correspond to first signs of infection, the hypothesis of direct contact through airborne droplets during primary infection and therefore during inspiration is not plausible. The aim of this study is to evaluate if a secondary spread to the olfactory groove in a retrograde manner during expiration could be more probable.

Methods

Four three-dimensional virtual models were obtained from actual CT scans and used to simulate expiratory droplets. The volume mesh consists of 25 million of cells, the simulated condition is a steady expiration, driving a flow rate of 270 ml/s, for a duration of 0.6 seconds. The droplet diameter is of 5 μm.

Results

The analysis of the simulations shows the virus to have a high probability to be deployed in the rhinopharynx, on the tail of medium and upper turbinates. The possibility for droplets to access the olfactory mucosa during the expiratory phase is lower than other nasal areas, but consistent.

Discussion

The data obtained from these simulations demonstrates the virus can be deployed in the olfactory groove during expiration. Even if the total amount in a single act is scarce, it must be considered it is repeated tens of thousands of times a day, and the source of contamination continuously acts on a timescale of several days. The present results also imply CNS penetration of SARS-CoV-2 through olfactory mucosa might be considered a complication and, consequently, prevention strategies should be considered in diseased patients.
Molecular pathways associated with Kallikrein 6 overexpression in colorectal cancer
Authors: Pandey Ritu , Zhou Muhan , Chen Yuliang , Darmoul Dalila , Kisiel Conner C. , Nfonsam Valentine N. , Ignatenko Natalia A.
Published: December 2020

Colorectal cancer (CRC) remains one of leading causes of cancer-related death worldwide. The high mortality of CRC is related to its ability to metastasize to distant organs. Current management of the CRC disease is limited due to the need of more extensive molecular characterization of tumor biomarkers. Kallikrein 6 (KLK6) is a member of the fifteen-gene family of kallikrein-related peptidases. KLK6 is overexpressed in CRC and contributes to cancer cell invasion through its proteolytic degradation of the extracellular matrix and recently discovered regulation of metastasis signaling pathways.

The goal of this study was to evaluate the clinical features, CRC molecular subtypes, mutational and gene expression patterns of the CRC tumors with overexpressed KLK6 in order to identify KLK6-associated markers for the CRC prognosis and treatment. RNA-Seq data from the CRC patients with a significantly elevated KLK6 transcript levels (KLK6-high group) (Z-score higher than-1.96) were identified in the Cancer Genome Atlas (TCGA) database and processed for clinical, molecular evaluation and bioinformatic analysis, using Gene Ontology (GO), Phenotype and Reactome enrichment and protein interaction methods. KLK6-high cases had a distinct spectrum of mutations in titin (TTN), APC, K-RAS and MUC 16 genes. Differentially expressed genes (DEGs) unique to KLK6-high group were clustered to regulatory pathways controlling the cell signaling, extracellular matrix organization, and cell communication regulation. The members of kallikrein family (KLK7, KLK8, KLK10), keratins (KRT6A, 6B, 15, 16, 19, 80), extracellular matrix proteins (integrin 4B), small proline rich repeat proteins (SPRRs), S100A families, protein trafficking genes (SYL1) and signaling genes within TGF-β, FOS and Ser/Thr protein kinase pathways were recognized as the top KLK6-interaction partners. Expression of selected KLK6-associated genes was validated in a subset of paired normal and tumor CRC patient-derived organoid cultures.

The performed analyses identified KLK6 itself and a set of genes, which are co-expressed with KLK6, as potential clinical biomarkers for the management of the CRC disease.
How long do nursing staff take to measure and record patients’ vital signs observations in hospital? A time-and-motion study
Authors: Dall’Ora Chiara , Griffiths Peter , Hope Joanna , Briggs Jim , Jones Jeremy , Gerry Stephen , Redfern Oliver
Published: December 2020

Introduction

Monitoring vital signs in hospital is an important part of safe patient care. However, there are no robust estimates of the workload it generates for nursing staff. This makes it difficult to plan adequate staffing to ensure current monitoring protocols can be delivered.

Objective

To estimate the time taken to measure and record one set of patient’s vital signs observations; and to identify factors associated with time to measure and record one set of patient’s vital signs observations.

Methods

We undertook a time-and-motion study of 16 acute medical or surgical wards across four hospitals in England. One hospital recorded vital signs on paper, while three recorded measurements on electronic devices. Two trained observers followed a standard operating procedure to record the time taken to measure and record vital sign observations. We used mixed-effects models to estimate the mean time using whole observation rounds, which included preparation time, or time spent taking observations at the bedside. We tested whether our estimates were influenced by nurse, ward and hospital factors.

Results

After excluding non-vital signs related interruptions, dividing the length of an observation round by the number of observations in that round yielded an estimated time per observation set of 5 minutes and 1 second (95% Confidence Interval (CI) = 4:39-5:24). If interruptions within the round were included, the estimated time was 6:26 (95% CI = 6:01-6:50). If only time taking each patient’s observations at the bedside was considered, after excluding non-vital signs related interruptions the estimated time was 3:45 (95% CI = 3:32-3:58). We found no substantial differences by hospital, ward or nurse characteristics, despite different systems for recording observations being used across the hospitals.

Discussion

The time taken to observe and record a patient’s vital signs is considerable, so changes to recommended observation frequency could have major workload implications. Variation in estimates derived from previous studies may, in part, arise from a lack of clarity about what was included in the reported times. We found no evidence that nurses save time when using electronic vital signs recording, or that the grade of staff taking the observation influenced the time taken.

Conclusions

Taking and recording vital signs observations is time consuming and the impact of interruptions and preparation away from the bedside is considerable. When considering the nursing workload around vital signs observations, no assumption of relative efficiency should be made if different technologies or staff groups are deployed.
Contacts and behaviours of university students during the COVID-19 pandemic at the start of the 2020/21 academic year
Authors: Nixon Emily , Trickey Adam , Christensen Hannah , Finn Adam , Thomas Amy , Relton Caroline , Montgomery Clara , Hemani Gibran , Metz Jane , Walker Josephine G. , Turner Katy , Kwiatkowska Rachel , Sauchelli Sarah , Danon Leon , Brooks-Pollock Ellen
Published: December 2020

CONQUEST (COroNavirus QUESTionnaire) is an online survey of contacts, behaviour, and COVID-19 symptoms for University of Bristol (UoB) staff/students. We analysed survey results from the start of the 2020/2021 academic year, prior to the second national lockdown (14/09/2020-01/11/2020), where COVID-19 outbreaks led to lockdown of some student halls of residence. The aim of these analyses was to enhance knowledge of student contact patterns to inform infection disease mathematical modelling approaches.

Responses captured information on demographics, contacts on the previous day, symptoms and self-isolation during the prior week, and COVID-19 status.

740 students provided 1261 unique records. Of 42 (3%) students testing positive in the prior fortnight, 99% had been self-isolating. The median number of contacts on the previous day was 2 (interquartile range: 1-5), mode: 1, mean: 6.1; 8% had ≥20 contacts. 57% of student contacts were other UoB students/staff.

Most students reported few daily contacts but there was heterogeneity, and some reported many. Around 40% of student contacts were with individuals not affiliated with UoB, indicating potential for transmission to non-students/staff.