bluuebunny/crossref_metadata_2025 huggingface dataset:
An observational study of initial HIV RNA decay following initiation of combination antiretroviral treatment during pregnancy
Authors: Alagaratnam Jasmini , Peters Helen , Francis Kate , Kay Natasha , Gilleece Yvonne , Finnerty Fionnuala P. , Grimes Rosanna E. , Parry Sarah , Portman Mags , Wait Brenton C. , Shah Rimi , Roedling Sherie , Hawkins David A. , Chitty Sarah , Sarner Liat , Marcus Rebecca , Hartley Anna , Nori Achyuta V. , Rosenvinge Melanie , Taylor Graham P. ,   the London HIV Perinatal Research Group
Published: July 2020

Background

In pregnancy, reduction of HIV plasma viral load (pVL) for the prevention of vertical transmission is time-constrained. The study primary objective is to investigate factors associated with faster initial HIV RNA half-life decay when combination antiretroviral treatment (cART) is initiated in pregnancy.

Methods

This was a multicentre, retrospective, observational study, conducted in south England, United Kingdom, between August 2001 and February 2018. Data were extracted from case notes of eligible women initiating cART during the index pregnancy. Anonymised data were collated and analysed centrally. Regression analyses were conducted to determine factors associated with faster HIV RNA half-life decay in the first 14 days after commencing cART (first-phase), and with achieving an undetectable maternal pVL by 36 weeks’ gestation. We then assessed whether HIV- and obstetric- related parameters differed by antiretroviral third agent class and whether the proportions of women with undetectable pVL at 36 weeks’ gestation and at delivery differed by antiretroviral third agent class.

Results

Baseline pVL was the only independent factor associated with faster first-phase HIV RNA half-life decay on commencing cART. Lower pVL on day 14 after starting cART was associated with an increased likelihood of achieving an undetectable pVL by 36 weeks’ gestation. Integrase inhibitor-based cART was associated with a faster first-phase HIV RNA half-life decay on commencing cART. Overall, 73% and 85% of women had an undetectable pVL at 36 weeks’ gestation and at delivery respectively, with no significant difference by antiretroviral third agent class.

Conclusions

Only high baseline pVL independently contributed to a faster rate of first-phase viral half-life decay. pVL at 14 days after initiating cART allows early identification of treatment failure. In the first 14 days after initiating cART in pregnancy, integrase inhibitor-based cART reduced maternal pVL faster than protease inhibitor- and non-nucleoside reverse transcriptase-based cART. While our study findings support INSTI use when initiated in pregnancy especially when initiated at later gestations and in those with higher baseline pVL, other non-INSTI based cART with more data on safety in pregnancy also performed well.
Quantitative clinical assessment of motor function during and following LSVT-BIG® therapy
Authors: Flood Matthew W. , O’Callaghan Ben P. F. , Diamond Paul , Liegey Jérémy , Hughes Graham , Lowery Madeleine M.
Published: July 2020

Background

LSVT-BIG® is an intensively delivered, amplitude-oriented exercise therapy reported to improve mobility in individuals with Parkinson’s disease (PD). However, questions remain surrounding the efficacy of LSVT-BIG® when compared with similar exercise therapies. Instrumented clinical tests using body-worn sensors can provide a means to objectively monitor patient progression with therapy by quantifying features of motor function, yet research exploring the feasibility of this approach has been limited to date. The aim of this study was to use accelerometer-instrumented clinical tests to quantify features of gait, balance and fine motor control in individuals with PD, in order to examine motor function during and following LSVT-BIG® therapy.

Methods

Twelve individuals with PD undergoing LSVT-BIG® therapy, eight non-exercising PD controls and 14 healthy controls were recruited to participate in the study. Functional mobility was examined using features derived from accelerometry recorded during five instrumented clinical tests: 10 m walk, Timed-Up-and-Go, Sit-to-Stand, quiet stance, and finger tapping. PD subjects undergoing therapy were assessed before, each week during, and up to 13 weeks following LSVT-BIG®.

Results

Accelerometry data captured significant improvements in 10 m walk and Timed-Up-and-Go times with LSVT-BIG® (p <  0.001), accompanied by increased stride length. Temporal features of the gait cycle were significantly lower following therapy, though no change was observed with measures of asymmetry or stride variance. The total number of Sit-to-Stand transitions significantly increased with LSVT-BIG® (p <  0.001), corresponding to a significant reduction of time spent in each phase of the Sit-to-Stand cycle. No change in measures related to postural or fine motor control was observed with LSVT-BIG®. PD subjects undergoing LSVT-BIG® showed significant improvements in 10 m walk (p <  0.001) and Timed-Up-and-Go times (p = 0.004) over a four-week period when compared to non-exercising PD controls, who showed no week-to-week improvement in any task examined.

Conclusions

This study demonstrates the potential for wearable sensors to objectively quantify changes in motor function in response to therapeutic exercise interventions in PD. The observed improvements in accelerometer-derived features provide support for instrumenting gait and sit-to-stand tasks, and demonstrate a rescaling of the speed-amplitude relationship during gait in PD following LSVT-BIG®.
Detection of low-level HCV variants in DAA treated patients: comparison amongst three different NGS data analysis protocols
Authors: Caputo Valeria , Diotti Roberta Antonia , Boeri Enzo , Hasson Hamid , Sampaolo Michela , Criscuolo Elena , Bagaglio Sabrina , Messina Emanuela , Uberti-Foppa Caterina , Castelli Matteo , Burioni Roberto , Mancini Nicasio , Clementi Massimo , Clementi Nicola
Published: July 2020

Background

Notwithstanding the efforts of direct-acting antivirals (DAAs) for the treatment of chronically infected hepatitis C virus (HCV) patients, concerns exist regarding the emergence of resistance-associated substitutions (RAS) related to therapy failure. Sanger sequencing is still the reference technique used for the detection of RAS and it detects viral variants present up to 15%, meaning that minority variants are undetectable, using this technique. To date, many studies are focused on the analysis of the impact of HCV low variants using next-generation sequencing (NGS) techniques, but the importance of these minority variants is still debated, and importantly, a common data analysis method is still not defined.

Methods

Serum samples from four patients failing DAAs therapy were collected at baseline and failure, and amplification of NS3, NS5A and NS5B genes was performed on each sample. The genes amplified were sequenced using Sanger and NGS Illumina sequencing and the data generated were analyzed with different approaches. Three different NGS data analysis methods, two homemade in silico pipeline and one commercially available certified user-friendly software, were used to detect low-level variants.

Results

The NGS approach allowed to infer also very-low level virus variants. Moreover, data processing allowed to generate high accuracy data which results in reduction in the error rates for each single sequence polymorphism. The results improved the detection of low-level viral variants in the HCVquasispeciesof the analyzed patients, and in one patient a low-level RAS related to treatment failure was identified. Importantly, the results obtained from only two out of the three data analysis strategies were in complete agreement in terms of both detection and frequency of RAS.

Conclusions

These results highlight the need to find a robust NGS data analysis method to standardize NGS results for a better comprehension of the clinical role of low-level HCV variants. Based on the extreme importance of data analysis approaches for wet-data interpretation, a detailed description of the used pipelines and further standardization of the in silico analysis could allow increasing diagnostic laboratory networking to unleash true potentials of NGS.
The impact on functioning of second-generation antipsychotic medication side effects for patients with schizophrenia: a worldwide, cross-sectional, web-based survey
Authors: Tandon Rajiv , Lenderking William R. , Weiss Catherine , Shalhoub Huda , Barbosa Carla Dias , Chen Jun , Greene Mallik , Meehan Stine R. , Duvold Laëtitia Bouérat , Arango Celso , Agid Ofer , Castle David
Published: July 2020

Background

It is well established that the different antipsychotics used for schizophrenia symptoms differ substantially in their side effects. However, relatively little is known about the impact of these side effects on functioning from the patient’s perspective. We aimed to understand how key side effects of second-generation antipsychotics impact the functioning and quality of life (QoL) of patients with schizophrenia.

Methods

This is a cross-sectional, web-based survey of patient-reported side effect burden of antipsychotic drugs in adults with schizophrenia. The survey was deployed in the United States, Canada, Australia, Spain, Italy, Norway, and Denmark. It included sociodemographic and clinical questions, the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF), and the Glasgow Antipsychotic Side-Effect Scale (GASS). Eight pre-defined key side effects classified as activating (“Shaky hands or arms,” “Restlessness,” and “Difficulty sleeping”), sedating (“Sleepy during the day”, “Feeling drugged or like a zombie,” and “Feeling dizzy/Fainted”) or other side effects (“Problems enjoying sex” and “Gaining weight”), and additional questions related to impacts on function and quality of life were asked.

Results

In total, 435 participants (mean age: 38 years, 53.8% female) were included. The total Q-LES-Q-SF score indicated overall medium satisfaction with their quality of life (score of 44.3; possible range 14–70). The most prevalent side effects were “Sleepy during the day” (83.2%), “Difficulty sleeping” (74.7%), “Dry mouth” (63.9%), “Problems enjoying sex” (53.4%) and “Gaining weight” (52.4%). Women reported the side effects of “Sleepy during the day”, “Problems enjoying sex” and “Gaining weight” more frequently than men. Key side effects impacted physical, social, occupational and psychological aspects of functioning. Patients with key side effects often felt frustrated by their experiences. Total Q-LES-Q-SF score showed a significant inverse correlation with the score of pre-defined groups of side effects indicating worse QoL in association with more severe key side effects in these patients.

Conclusion

Stable patients with schizophrenia taking second-generation antipsychotics live with many side effects, including activating and sedating side effects, sexual side effects, and weight gain. Presence of these side effects is associated with substantial impacts across all aspects of daily functioning and lower quality of life and satisfaction.
Misinformation and de-contextualization: international media reporting on Sweden and COVID-19
Authors: Irwin Rachel Elisabeth
Published: July 2020

In the first month of the 2020 COVID-19 pandemic, Sweden took the same strategy as most other countries, working to “flatten the curve,” by slowing transmission so that the healthcare system could cope with the disease. However, unlike most other countries, much of Sweden’s implementation focused on voluntary and stepwise action, rather than legislation and compulsory measures, leading to considerable attention in the international media.

Six main narratives emerged in the international media reporting on Sweden during the first month of the COVID-19 pandemic: (1) Life is normal in Sweden, (2) Sweden has a herd immunity strategy, (3) Sweden is not following expert advice, (4) Sweden is not following WHO recommendations (5) the Swedish approach is failing and (6) Swedes trust the government. While these narratives are partially grounded in reality, in some media outlets, the language and examples used to frame the story distorted the accuracy of the reporting.

This debate examines the ways in which international media both constructs and represents a pandemic, and the implications for how researchers engage with news and social media. Cross-country comparison and the sharing of best practice are reliant on accurate information. The Swedish example underlines the importance of fact checking and source critique and the need for precision when presenting data and statistics. It also highlights limitations of using culture as an explanation for behavior, and the pitfalls of evaluating policy during a pandemic.
Three-dimensional-printed customized prosthesis for pubic defect: prosthesis design and surgical techniques
Authors: Zhang Yuqi , Min Li , Lu Minxun , Wang Jie , Wang Yitian , Luo Yi , Zhou Yong , Duan Hong , Tu Chongqi
Published: July 2020

Background

This study is to describe the detailed design and surgical techniques of three-dimensional (3D)-printed customized prosthesis for pubic bone defect.

Patients and methods

Five patients under type III resections were included in this study. Based on radiography data, 3D pelvic model was established and virtual surgery was simulated. Detailed anatomy data were measured including the size and arc of normal pubis, the size of residual bone in acetabular side. Different fixation ways were considered according to shape of defect. After features modification and porous structure design, prostheses were fabricated. The osteotomy guides and plastic models were used during surgery.

Result

Of 5 cases, the prostheses consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 13.6 months (range, 8-24 months). For partial pubis removed cases, the mean length and width of narrowest part of normal superior pubis were 13.19 mm (range, 12.51-14.12 mm) and 7.80 mm (range, 7.18-8.26 mm) respectively. Mean arc of normal pubis was 2.71 rad (range, 2.66-2.73 rad). For the entire pubis resection cases, the mean diameter of narrowest parts and length of normal superior pubis were 11.52 mm (range, 11.13-11.91 mm) and 64.78 mm (range, 63.46-66.09 mm), while the diameter of narrowest part and length of normal inferior pubis were 7.37 mm (range, 7.20-7.54 mm) and 86.43 mm (range, 84.28-88.57 mm). Mean length and arc of intramedullary stem was 20 mm (range, 18-21 mm) and 2.7 rad. Mean screw holes number was 6.3 (range, 6-7) while ultimate screws number in surgeries was 4.3 (range, 4-5). Porous structure with 600-μm-pore size and 70% porosity was applied in parts of contact with residual bone.

Conclusion

3D-printed customized prostheses could be a feasible option to reconstruct bone defect after type III resection. The design of 3D-printed customized prostheses is a multi-step process which is based on strict anatomic measurement.
Integration of clinical parameters, genotype and epistaxis severity score to guide treatment for hereditary hemorrhagic telangiectasia associated bleeding
Authors: Beckman Joan D. , Li Quefeng , Hester Samuel T. , Leitner Ofri , Smith Karen L. , Kasthuri Raj S.
Published: July 2020

Background

Hereditary Hemorrhagic Telangiectasia (HHT) is a rare inherited disorder characterized by development of mucocutaneous telangiectases and visceral organ arteriovenous malformations, which can lead to recurrent, spontaneous bleeding and development of iron deficiency anemia. The primary objective of this study was to ascertain the relationship between epistaxis severity scores (ESS), laboratory values, genotype, and phenotype in HHT. Our secondary objective was to assess efficacy of systemic antifibrinolytic therapy in reducing ESS in HHT.

Methodology

We conducted a retrospective review of patients seen at the UNC HHT Center from January 1, 2009 to February 28, 2015. ESS, demographics, and results of genetic testing were abstracted from the medical record. Response to antifibrinolytic therapy was evaluated by comparing pre-post ESS.

Results

One hundred and forty nine patients were eligible with 116 having genetic testing and 33 without. Age, hemoglobin and ferritin levels were predictive of ESS. Of the 116 patients that underwent genetic testing: 63 had an ACVRL1 mutation, 40 had an ENG mutation, 2 had a SMAD4 mutation, and 11 patients had no pathologic HHT genetic variation detected. Compared to patients without a detectable HHT-associated genetic variation, patients with a HHT-associated genetic variation had higher ESS scores (p < 0.05). Neither ESS nor genotype was predictive of pulmonary or brain AVMs. Twenty-four HHT patients with ESS > 4 were started on antifibrinolytic therapy (tranexamic acid or aminocaproic acid) and had a post-treatment ESS recorded. All patients had a decrease in ESS of > 0.71 (minimal meaningful difference), but patients taking antifibrinolytics displayed larger decreases. No patients on antifibrinolytics experienced a VTE with median follow up of 13 months.

Conclusions

We demonstrate that the ESS correlates with age, hemoglobin and ferritin. Additionally, we demonstrate that HHT patients with genetic mutations have higher ESS scores. Our data demonstrate that antifibrinolytics are effective in decreasing epistaxis severity and safe with long-term use in HHT patients.
Deciphering cellular transcriptional alterations in Alzheimer’s disease brains
Authors: Wang Xue , Allen Mariet , Li Shaoyu , Quicksall Zachary S. , Patel Tulsi A. , Carnwath Troy P. , Reddy Joseph S. , Carrasquillo Minerva M. , Lincoln Sarah J. , Nguyen Thuy T. , Malphrus Kimberly G. , Dickson Dennis W. , Crook Julia E. , Asmann Yan W. , Ertekin-Taner Nilüfer
Published: July 2020

Large-scale brain bulk-RNAseq studies identified molecular pathways implicated in Alzheimer’s disease (AD), however these findings can be confounded by cellular composition changes in bulk-tissue. To identify cell intrinsic gene expression alterations of individual cell types, we designed a bioinformatics pipeline and analyzed three AD and control bulk-RNAseq datasets of temporal and dorsolateral prefrontal cortex from 685 brain samples. We detected cell-proportion changes in AD brains that are robustly replicable across the three independently assessed cohorts. We applied three different algorithms including our in-house algorithm to identify cell intrinsic differentially expressed genes in individual cell types (CI-DEGs). We assessed the performance of all algorithms by comparison to single nucleus RNAseq data. We identified consensus CI-DEGs that are common to multiple brain regions. Despite significant overlap between consensus CI-DEGs and bulk-DEGs, many CI-DEGs were absent from bulk-DEGs. Consensus CI-DEGs and their enriched GO terms include genes and pathways previously implicated in AD or neurodegeneration, as well as novel ones. We demonstrated that the detection of CI-DEGs through computational deconvolution methods is promising and highlight remaining challenges. These findings provide novel insights into cell-intrinsic transcriptional changes of individual cell types in AD and may refine discovery and modeling of molecular targets that drive this complex disease.
Evidence for a causal role by human papillomaviruses in prostate cancer – a systematic review
Authors: Lawson James S. , Glenn Wendy K.
Published: July 2020

It is hypothesised that high risk for cancer human papillomaviruses (HPVs) have a causal role in prostate cancer.

In 26 case control studies, high risk HPVs have been identified in benign and prostate cancers. High risk HPVs were identified in 325 (22.6%) of 1284 prostate cancers and in 113 (8.6%) of 1313 normal or benign prostate controls (p = 0.001).

High risk HPVs of the same type have been identified in both normal and benign prostate tissues prior to the development of HPV positive prostate cancer. High risk HPVs can be associated with inflammatory prostatitis leading to benign prostate hyperplasia and later prostate cancer. Normal human prostate epithelial cells can be immortalised by experimental exposure to HPVs. HPVs are probably sexually transmitted.

The role of HPVs in prostate cancer is complex and differs from HPVs associated cervical cancer. HPV infections may initiate prostate oncogenesis directly and influence oncogenesis indirectly via APOBEC enzymes. HPVs may collaborate with other pathogens in prostate oncogenesis.

Although HPVs are only one of many pathogens that have been identified in prostate cancer, they are the only infectious pathogen which can be prevented by vaccination.

A causal role for HPVs in prostate cancer is highly likely.
National hospital quality measures for surgical site infections in South Korea: a survey among 20 expert physicians
Authors: Ryu Mikyung , Yoo Hyerim , Choi Yun-Kyoung
Published: July 2020

Background

Surgical site infection (SSI) is recognized as an important quality indicator for patient safety. In Korea, the use of prophylactic antibiotics for surgery is conducted as a national quality measures related to SSI prevention. The objective of the present study was to investigate physicians’ perceptions of hospital quality measures for SSI as well as identify obstacles that might hinder its implementation in South Korea.

Method

Online-based questionnaires were administered twice. Twenty physician experts who were members of the Healthcare Review and Assessment Committee that was constituted for the “Assessment of prophylactic use of antibiotics for surgery” participated in the study. The first survey comprised open-ended questions that were designed to elicit the physician who could hinder the implementation of SSI indicators. The second survey, which was developed on the basis of the initial survey’s results, consisted of 10 closed-ended questions about the feasibility of objective perception and the need for subjectivity, with regard to SSI.

Results

From among the 20 physicians, we collected data from 16 respondents in the first survey (response rate of 80%) and 15 respondents in the second survey (response rate of 75%).Thirty-one percent of the respondents supported hospital SSI evaluations, and 69% expressed objections. The obstacles that were perceived as being able to hinder hospital SSI evaluations pertained to difficulties in collecting data, unavailability of information, possibility of underreporting, and redundancy of the inquiry undertaken by the Korean National Healthcare-associated Infections Surveillance System-SSI. Physician experts provide significantly higher ratings for the clinical indicator, rate of readmission due to SSI, both in terms of feasibility and need, when evaluating the results of SSI prevention in hospitals.

Conclusion

The results of this study show that physicians perceive the need for QI development of hospital SSI measurements to prevent nation-wide SSIs in Korea. However, the feasibility of hospital SSI measurements is low. To develop QIs of hospital SSIs using health insurance claims data, it is necessary to develop a methodology for claims data-based surveillance systems and a data collection system in order to increase the sensitivity and validity of post-operative SSI detection.
Feasibility of the Archercise biofeedback device to strengthen foot musculature
Authors: Latey Penelope J. , Eisenhuth John , McKay Marnee J. , Hiller Claire E. , Sureshkumar Premala , Nightingale Elizabeth J. , Burns Joshua
Published: July 2020

Background

Foot muscle weakness can produce foot deformity, pain and disability. Toe flexor and foot arch exercises focused on intrinsic foot muscle strength and functional control may mitigate the progression of foot deformity and disability. Ensuring correct exercise technique is challenging due to the specificity of muscle activation required to complete some foot exercises. Biofeedback has been used to improve adherence, muscle activity and movement patterns. We investigated the feasibility of using a novel medical device, known as “Archercise”, to provide real‐time biofeedback of correct arch movement via pressure change in an inflatable bladder, and foot location adherence via sensors embedded in a footplate during four‐foot exercises.

Methods

Thirty adults (63% female, aged 23–68 years) performed four‐foot exercises twice on the Archercise sensor footplate alone and then with biofeedback. One‐way repeated measures ANOVA with pairwise comparisons were computed to assess the consistency of the exercise protocol between trial 1 and trial 2 (prior to biofeedback), and the effectiveness of the Archercise biofeedback device between trial 2 and trial 3 (with biofeedback). Outcome measures were: Arch movement exercises of arch elevation and lowering speed, controlled arch elevation, controlled arch lowering, endurance of arch elevation; Foot location adherence was determined by percentage of time the great toe, fifth toe and heel contacted footplate sensors during testing and were analysed with paired sample t‐tests. Participant survey comments on the use of Archercise with biofeedback were reported thematically.

Results

Seventeen (89%) arch movement and foot location variables were collected consistently with Archercise during the foot exercises. Archercise with biofeedback improved foot location adherence for all exercises (p = 0.003–0.008), coefficient of determination for controlled arch elevation (p < 0.0001) and endurance area ratio (p = 0.001). Twenty‐nine (97%) participants reported Archercise with biofeedback, helped correct exercise performance.

Conclusions

Archercise is a feasible biofeedback device to assist healthy participants without foot pathologies perform foot doming exercises.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR): 12616001559404. Registered 11 November 2016, http://www.ANZCTR.org.au/ACTRN12616001559404p.aspx
Correlation between functional ability, toe flexor strength, and plantar pressure of hallux valgus in young female adults: a cross‐sectional study
Authors: Yokozuka Mieko , Okazaki Kanako , Sakamoto Yuko , Takahashi Koko
Published: July 2020

Background

The prevalence of hallux valgus (HV) increases with age in females. Several studies have investigated the relationship between foot problems, including HV, and falls in older individuals. This study aimed to examine whether HV causes a decline in functional activity in young females and also evaluate the relationship between HV angle, functional activity, toe flexor strength, and plantar pressure.

Methods

We assessed 94 females (mean age, 19.6 ± 1.3 years; mean body mass index, 21.2 ± 2.0 kg/m2) not currently receiving treatment for lower limb disease. HV angle was determined using their footprint. Functional reach (FR) and maximum step length (MSL), toe flexor strength, and plantar pressure were measured. Plantar pressure was measured during walking. We also calculated FR and the pressure in eight regions (first toe, second through fifth toes, first metatarsal, second through fourth metatarsals, fifth metatarsal, midfoot, medial heel, and lateral heel).

Results

There were 39 and 55 participants in the HV and no HV groups, respectively. FR and MSL did not differ significantly between the HV and no HV groups. Toe flexor strength was significantly different between the HV and no HV groups (26.69 ± 9.68 vs. 32.19 ± 8.55, respectively) (p = 0.002, β = 0.206). During walking, plantar pressure was significantly lower in the second through fifth toes in the HV group (p = 0.005, β = 0.187). During FR, plantar pressure was significantly greater in the first metatarsal in the HV group (p = 0.016, β = 0.338). HV angle was negatively correlated with toe flexor strength (r = − 0.315, p = 0.002, β = 0.121) and plantar pressure during walking in the second through fifth toes (r = − 0.362, p < 0.001, β = 0.047), and positively correlated with plantar pressure during FR in the first metatarsal (r = 0.308, p = 0.002, β = 0.137). Toe flexor strength was negatively correlated with plantar pressure during FR in the second through fourth metatarsals (r = − 0.318, p = 0.002, β = 0.115), and there was a positive correlation with MSL (r = 0.330, p = 0.001, β = 0.092).

Conclusions

This study confirmed that HV reduces toe flexor strength and affects forefoot pressure during walking and FR in young females. Moreover, the toe flexor strength affects MSL. Efforts to prevent the onset and deterioration of HV from a young age might help reduce the risk of falling when older.
National Early Warning Score 2 (NEWS2) on admission predicts severe disease and in-hospital mortality from Covid-19 – a prospective cohort study
Authors: Myrstad Marius , Ihle-Hansen Håkon , Tveita Anders Aune , Andersen Elizabeth Lyster , Nygård Ståle , Tveit Arnljot , Berge Trygve
Published: July 2020

Background

There is a need for validated clinical risk scores to identify patients at risk of severe disease and to guide decision-making during the covid-19 pandemic. The National Early Warning Score 2 (NEWS2) is widely used in emergency medicine, but so far, no studies have evaluated its use in patients with covid-19. We aimed to study the performance of NEWS2 and compare commonly used clinical risk stratification tools at admission to predict risk of severe disease and in-hospital mortality in patients with covid-19.

Methods

This was a prospective cohort study in a public non-university general hospital in the Oslo area, Norway, including a cohort of all 66 patients hospitalised with confirmed SARS-CoV-2 infection from the start of the pandemic; 13 who died during hospital stay and 53 who were discharged alive. Data were collected consecutively from March 9th to April 27th 2020. The main outcome was the ability of the NEWS2 score and other clinical risk scores at emergency department admission to predict severe disease and in-hospital mortality in covid-19 patients. We calculated sensitivity and specificity with 95% confidence intervals (CIs) for NEWS2 scores ≥5 and ≥ 6, quick Sequential Organ Failure Assessment (qSOFA) score ≥ 2, ≥2 Systemic Inflammatory Response Syndrome (SIRS) criteria, and CRB-65 score ≥ 2. Areas under the curve (AUCs) for the clinical risk scores were compared using DeLong’s test.

Results

In total, 66 patients (mean age 67.9 years) were included. Of these, 23% developed severe disease. In-hospital mortality was 20%. Tachypnoea, hypoxemia and confusion at admission were more common in patients developing severe disease. A NEWS2 score ≥ 6 at admission predicted severe disease with 80.0% sensitivity and 84.3% specificity (Area Under the Curve (AUC) 0.822, 95% CI 0.690–0.953). NEWS2 was superior to qSOFA score ≥ 2 (AUC 0.624, 95% CI 0.446–0.810, p < 0.05) and other clinical risk scores for this purpose.

Conclusion

NEWS2 score at hospital admission predicted severe disease and in-hospital mortality, and was superior to other widely used clinical risk scores in patients with covid-19.
Risk factors and intestinal microbiota: Clostridioides difficile infection in patients receiving enteral nutrition at Intensive Care Units
Authors: Wang Daosheng , Dong Danfeng , Wang Chen , Cui Yingchao , Jiang Cen , Ni Qi , Su Tongxuan , Wang Guanzheng , Mao Enqiang , Peng Yibing
Published: July 2020

Background

Clostridioides difficile infection (CDI) is a leading cause of nosocomial diarrhea. Patients receiving enteral nutrition (EN) in the intensive care unit (ICU) are potentially at high risk of CDI. In the present study, we assessed the risk factors and intestinal microbiome of patients to better understand the occurrence and development of CDI.

Methods

Patients were screened for C. difficile every week after starting EN, and their clinical records were collected for risk factor identification. Fecal samples were analyzed using 16S rRNA sequencing to evaluate the intestinal microbiota.

Results

Overall incidence of CDI was 10.7% (18/168 patients). History of cerebral infarction was significantly associated with CDI occurrence (OR, 9.759; 95% CI, 2.140–44.498), and treatment with metronidazole was identified to be protective (OR, 0.287; 95% CI, 0.091–0.902). Patients with EN had lower bacterial richness and diversity, accompanied by a remarkable decrease in the abundance of Bacteroides, Prevotella_9, Ruminococcaceae, and Lachnospiraceae. Of these patients, acquisition of C. difficile resulted in a transient increase in microbial diversity, along with consistent alterations in the proportion of some bacterial taxa, especially Ruminococcaceae and Lachnospiraceae. Upon initiation of EN, patients who were positive for C. difficile later showed an enhanced load of Bacteroides, which was negatively correlated with the abundance of C. difficile when CDI developed.

Conclusion

ICU patients receiving EN have a high prevalence of CDI and a fragile intestinal microbial environment. History of cerebral infarction and prior treatment with metronidazole are considered as vital risk and protective factors, respectively. We propose that the emergence of CDI could cause a protective alteration of the intestinal microbiota. Additionally, Bacteroides loads seem to be closely related to the occurrence and development of CDI.
Progesterone receptor membrane component 1 regulates lipid homeostasis and drives oncogenic signaling resulting in breast cancer progression
Authors: Asperger Hannah , Stamm Nadia , Gierke Berthold , Pawlak Michael , Hofmann Ute , Zanger Ulrich M. , Marton Annamaria , Katona Robert L. , Buhala Andrea , Vizler Csaba , Cieslik Jan-Philipp , Ruckhäberle Eugen , Niederacher Dieter , Fehm Tanja , Neubauer Hans , Ludescher Marina
Published: July 2020

Background

PGRMC1 (progesterone receptor membrane component 1) is a highly conserved heme binding protein, which is overexpressed especially in hormone receptor-positive breast cancer and plays an important role in breast carcinogenesis. Nevertheless, little is known about the mechanisms by which PGRMC1 drives tumor progression. The aim of our study was to investigate the involvement of PGRMC1 in cholesterol metabolism to detect new mechanisms by which PGRMC1 can increase lipid metabolism and alter cancer-related signaling pathways leading to breast cancer progression.

Methods

The effect of PGRMC1 overexpression and silencing on cellular proliferation was examined in vitro and in a xenograft mouse model.

Next, we investigated the interaction of PGRMC1 with enzymes involved in the cholesterol synthesis pathway such as CYP51, FDFT1, and SCD1. Further, the impact of PGRMC1 expression on lipid levels and expression of enzymes involved in lipid homeostasis was examined. Additionally, we assessed the role of PGRMC1 in key cancer-related signaling pathways including EGFR/HER2 and ERα signaling.

Results

Overexpression of PGRMC1 resulted in significantly enhanced proliferation. PGRMC1 interacted with key enzymes of the cholesterol synthesis pathway, alters the expression of proteins, and results in increased lipid levels. PGRMC1 also influenced lipid raft formation leading to altered expression of growth receptors in membranes of breast cancer cells. Analysis of activation of proteins revealed facilitated ERα and EGFR activation and downstream signaling dependent on PGRMC1 overexpression in hormone receptor-positive breast cancer cells. Depletion of cholesterol and fatty acids induced by statins reversed this growth benefit.

Conclusion

PGRMC1 may mediate proliferation and progression of breast cancer cells potentially by altering lipid metabolism and by activating key oncogenic signaling pathways, such as ERα expression and activation, as well as EGFR signaling. Our present study underlines the potential of PGRMC1 as a target for anti-cancer therapy.
Unrevealing model compounds of soil conditioners impacts on the wheat straw autohydrolysis efficiency and enzymatic hydrolysis
Authors: Wu Xinxing , Tang Wei , Huang Chen , Huang Caoxing , Lai Chenhuan , Yong Qiang
Published: July 2020

Background

Soil-derived exogenous ash (EA) poses a challenge toward lignocellulosic autohydrolysis due to its buffering capacity. Previous works focusing on this phenomenon have failed to also investigate the role that soluble salts, and organic matter plays in this system. Herein, sodium phosphate and sodium humate were employed as model buffering compounds representing soluble salts and organic matter and dosed into a de-ashed wheat straw (DWS) autohydrolysis process to show the potential impacts of WS attached soil conditioners on the WS autohydrolysis efficiency which would further affect the enzymatic digestibility of autohydrolyzed WS.

Results

Results showed that with the increasing loadings of sodium phosphate and sodium humate resulted in elevated pH values (from 4.0 to 5.1 and from 4.1 to 4.7, respectively). Meanwhile, the reductions of xylan removal yields from ~ 84.3–61.4% to 72.3–53.0% by loading (1–30 g/L) sodium phosphate and sodium humate during WS autohydrolysis lead to a significant decrease of cellulose accessibilities which finally lead to a reduction of the enzymatic digestibility of autohydrolyzed WS from ~ 75.4–77.2% to 47.3–57.7%.

Conclusion

The existence of different types soil conditioner model compounds results in various component fractions from autohydrolyzed WS in the process of autohydrolysis. A lack of sufficient xylan removal was found to drive the significant decrease in enzymatic accessibility. The results demonstrated the various effects of two typical tested soil conditioners on WS autohydrolysis and enzymatic hydrolysis.
Associations between ethnicity, place of residence, hearing status of family and habilitation of children with hearing impairment
Authors: Goldblat Ester , Rivkin Dori , Konstantinov Viacheslav
Published: July 2020

Background

Hearing parents tend to have a strong preference for their deaf and hard-of-hearing children to acquire adequate speech, as opposed to use of sign language. Research reports the contribution of many variables to speech acquisition by children with hearing loss (HL). Yet, little is known about the association between ethnicity, place of residence, and hearing status of family members and mode of communication of young people with HL. The purpose of the present study was to examine whether mode of communication of young people with HL is associated with ethnicity, place of residence, and hearing status of family members.

Method

Participants were young adults with sensory-neural severe to profound HL, either congenital or acquired prior to age 3. Only participants without additional disabilities were included. The data on participants were extracted from records of the Ministry of Labor, Social Affairs and Social Services in Israel. The data for each participant in the study included mode of communication, gender, use of assistive device, ethnicity, geographic place of residence, and presence of first-degree relatives with HL. Regarding participants with a cochlear implant (CI), age at implantation was documented as well.

Results

Chi-square tests revealed significant associations between mode of communication and all of the study variables. In addition, all the study variables made a significant contribution to mode of communication. Regarding ethnicity, most of the ultra-Orthodox participants used oral language, while the majority of Israeli-Arab participants used sign language. Regarding geographical place of residence, lower rates of oral language use were found in the northern and southern districts of Israel.

Conclusions

The findings of the present study underline the need for better monitoring of Israeli-Arab children with HL and children residing in peripheral areas in Israel and for improving access to habilitation services.
Quantitative Measurement of Water Absorption of Coarse Lightweight Aggregates in Freshly-Mixed Concrete
Authors: Kim Yong-Hyok , Park Cho-Bum , Choi Byoung Il , Shin Tae Yong , Jun Yubin , Kim Jae Hong
Published: July 2020

The high water-absorption of lightweight aggregate causes a high slump loss and poor workability of concrete. A prewetting process is usually recommended to compensate for the workability problem, but its application needs more delicate consideration in field. A method is proposed to measure the additional water absorption of lightweight aggregate, and its application in cement paste and concrete mixes confirms the absorption amount remaining unaffected by the mix proportion. The additional water absorption in cement-based materials can be considered as a material property, and its value is smaller than the water absorption measured by a standard test method (water-soaking). Compensating the additional water absorption finally allows to use dry lightweight aggregates for concrete, which is more robust and stabler than taking a saturated surface-dry lightweight aggregates.
Solar wind parameter and seasonal variation effects on the South Atlantic Anomaly using Tsyganenko Models
Authors: Girgis Kirolosse M. , Hada Tohru , Matsukiyo Shuichi
Published: July 2020

We studied the space weather effects on the South Atlantic Anomaly (SAA) magnetic response using Tsyganenko models. For the physical parameters characterizing the SAA, the study considered the minimum magnetic field, the location (longitude and latitude) of the SAA center, and the area of the SAA. Regarding the space weather parameters, we considered the solar wind dynamic pressure, the interplanetary magnetic field components, $$B_{yIMF}$$

B

yIMF

and $$B_{zIMF}$$

B

zIMF

, the Dst index, and the geodipole tilting angle. To study the magnetic field response of the SAA, several different versions of the Tsyganenko models, namely, T96, T01, and TS05, were used to describe the external magnetic field contributions. The main internal magnetic field was calculated by the International Geomagnetic Reference Field (IGRF-12). The magnetic field study of the SAA was realized in long- and short-term (seasonal and diurnal) variations. We found that the Dst index and the geodipole tilting angle were the strongest influencing parameters on the SAA magnetic field response at all altitudes. Moreover, it was revealed that both magnetic poles might be a possible cause of the SAA magnetic field response, resulting from the space weather conditions. Furthermore, the magnetic field behavior of the SAA was affected by hourly variations, where the largest changes occurred at dayside.
Pathogenic effects of Beauveria bassiana and Bacillus thuringiensis on the population dynamics of Ephestia Kuehniella
Authors: Bahmani Negar , Latifian Masoud , Ostovan Hadi , Hesami Shahram
Published: July 2020

The most dominant pest of date stored in Khuzestan Province is Ephestia kuehniella Zeller (Lepidoptera: Pyralidae). In this study, the effects of Bacillus thuringiensis Kurstaki bacteria and Beauveria bassiana pathogenic fungi on the population dynamics of E. kuehniella date stock pest were investigated. To fulfill this, insectariums were kept in vitro at an average temperature of 27 ± 5 °C and a RH of 40 ± 5% for a duration of 6 months, equivalent to the maximum permitted shelf life of date. For sampling from 3 heights in 3 rows, one hole was randomly selected and a sample equal to 20 g of date was taken. Three samples were taken from each insectarium. During 25-week storage period of date treated with B. bassiana and Btk, 6 outbreaks occurred in the population of E. kuehniella. The mechanism of the epidemic is in the way that, once the population has increased to a certain threshold, the incidence of the pathogenic epidemic will be mass-dependent, leading to a decreasing trend in the pest population. Therefore, population reduction was estimated to be at 6 to 32 times that of the control. The highest disease mortality rate occurred at the egg and larval developmental stages, so the pathogens caused the highest mortality before the population entered the reproductive stage. Gradually, from the egg growth stage to the complete insect stage, a reduction was observed in the number of individuals which entered the subsequent growth stage. At all stages, the reduction in the treatment population group was faster than the control population. The highest reduction in the number of individuals entering the next developmental stage was associated with the larval developmental stage, followed by developmental stages of the adult, pupal, and egg. Regarding the highest potential of B. bassiana and BtK in reducing the stock pest population, it is very possible to exploit this interaction for biocontrol.

Graphical abstract
RETRACTED ARTICLE: The diagnostic value of combined dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in characterization of parotid gland tumors
Authors: EL-Adalany Mohamed Ali , Mousa Amany Ezzat Mohamed , EL-Metwally Dina
Published: July 2020

Background

MRI is considered to be the imaging modality of choice in preoperative diagnosis of parotid gland tumors and differentiating benign from malignant ones. Recently, functional MR imaging sequences including dynamic contrast-enhanced magnetic resonance imaging (DCE- MRI) and diffusion-weighted imaging (DWI) have significantly contributed to the diagnosis of head and neck masses. The purpose of this study was to evaluate the diagnostic value of combined DCE-MRI and DWI in characterization of parotid gland tumors.

Results

There was significant difference between benign and malignant parotid gland tumors as regard the type of time intensity curve (TIC) (P < 0.001). There was significant difference between pleomorphic adenoma (PMA) and malignant parotid gland tumors (MT) as regard mean ADC value (P = 0.046) and TTP (P = 0.002). There was no significant difference between Warthin’s tumor (WT) and malignant parotid gland tumors as regard the ADC value and TTP (P > 0.5); on the other hand, WT usually have high WR when compared with MT (P = 0.004). Combined use of DCE-MRI and DWI had 100% sensitivity, 90.5% specificity, and 93.3% accuracy in differentiating benign from malignant parotid gland tumors.

Conclusion

Combined use of DCE-MRI and DWI could result in high sensitivity, specificity, and diagnostic accuracy in characterization of parotid gland tumors.
Airflow limitation: is there a correlation between spirometry and quantitative computed tomography measurements in patients with chronic obstructive pulmonary disease?
Authors: Mahros Mohamed , Hosny Hossam , Ismail Ayman , Moussa Heba
Published: July 2020

Background

The ability of computed tomography (CT) in illustrating the pathology of lung parenchyma in patients with chronic obstructive pulmonary disease (COPD) was discussed previously in many articles. However, the correlation between airflow limitation that is evaluated by spirometry and its corresponding airway diameter that is measured by multislice computed tomography (MSCT) still under investigation. Therefore, the objective of our study was to answer the questions about possible correlation between forced expiratory volume in first second (FEV1%), forced vital capacity (FVC%), FEV1/FVC, and peak expiratory flow25–75% (PEF25–75%), both before bronchodilator and post it with the diameters of airway at 3 different levels either during inspiratory or expiratory phase of respiration.

Results

The quantitative MSCT results at RB1 (apical bronchus of the right upper lobe), RB10 (the posterior basal bronchus of the right lower lobe), and LB3 (the anterior bronchus of the left upper lobe) showed weak positive correlation with FEV1% during inspiratory phase of respiration (r = 0.19, 0.20, and 0.18; P = 0.23, 0.22, and 0.26 respectively), but this correlation became more stronger and significant during expiratory phase of respiration (r = 0.76, 0.78, and 0.66; P < 0.001).

Conclusions

Expiratory CT parameters were significantly correlated with the predicted peak expiratory flow in 1 s.