bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and validation of a risk signature based on extracellular matrix-related genes in gliomas
Authors: Liu Jia , Li Guilin
Published: April 2021

Gliomas have the highest incidence among primary brain tumors, and the extracellular matrix (ECM) plays a vital role in tumor progression. We constructed a risk signature using ECM-related genes to predict the prognosis of patients with gliomas.

mRNA and clinical data from glioma patients were downloaded from The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx) and Chinese Glioma Genome Atlas (CGGA) databases. Differentially expressed ECM-related genes were screened, and a risk signature was built using least absolute shrinkage and selection operator (LASSO) Cox regression. Cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT) was used to assess immune infiltration in different risk groups. Gene set enrichment analysis (GSEA) was performed to explore the molecular mechanisms of the genes employed in the risk score.

Differentially expressed ECM-related genes were identified, and their associated regulatory mechanisms were predicted via analysis of protein–protein interaction (PPI), transcription factor (TF) regulatory and TF coexpression networks. The established risk signature considered 17 ECM-related genes. The prognosis of the high-risk group was significantly worse than that of the low-risk group. We used the CGGA database to validate the signature. CIBERSORT indicated that the levels of naive B cells, activated memory CD4 T cells, regulatory T cells, gamma delta T cells, activated NK cells, monocytes, activated dendritic cells and activated mast cells were higher in the high-risk group. The levels of plasma cells, CD8 T cells, naive CD4 T cells, resting memory CD4 T cells, M0 macrophages, M1 macrophages, resting mast cells, and neutrophils were lower in the high-risk group. Ultimately, GSEA showed that the terms intestinal immune network for IgA production, primary immunodeficiency, and ECM receptor interaction were the top 3 terms enriched in the high-risk group. The terms Wnt signaling pathway, ErbB signaling pathway, mTOR signaling pathway, and calcium signaling pathway were enriched in the low-risk group.

We built a risk signature to predict glioma prognosis using ECM-related genes. By evaluating immune infiltration and biofunctions, we gained a further understanding of this risk signature. This risk signature could be an effective tool for predicting glioma prognosis.

This study did not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.
Comparison of acupuncture and pinaverium bromide in the treatment of irritable bowel syndrome
Authors: Li Huaiyu , Chen Yun , Hu Ziyi , Yi Ying , Ye Jing , Zhou Yuliang , Yu Zhiying , Tang Haiyi
Published: April 2021

Background:

Irritable bowel syndrome (IBS) is one of the most common chronic gastrointestinal diseases, and the current diagnosis of IBS is still based on symptoms and examination. Pinaverium bromide is commonly used as an antispasmodic in the treatment of IBS. But adverse effects of pinaverium bromide are common. Meta-analyses show that acupuncture has a positive therapeutic effect on IBS.

Methods:

Randomized controlled trials of comparing the efficacy of acupuncture and pinaverium bromide in the treatment of IBS will be searched in the relevant database: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). The studies selected will be exported to EndNote V.9.1 software. Data will be carried out independently from the selected articles by 2 reviewers. Any disagreement will be solved in consultation with a third reviewer.

Results:

Our study aims to compare the efficacy of acupuncture and pinaverium bromide in the treatment of IBS and to fill the lack of relevant evidence.

Conclusion:

Through the inclusion of relevant literature, the overall efficacy of acupuncture and pinaverium bromide in the treatment of IBS will be evaluated, and the gap between various acupuncture treatment measures will be further analyzed.

INPLASY registration number:

INPLASY 202130068.
The clinical course of critically ill COVID-19 patients receiving invasive mechanical ventilation with subsequent terminal weaning
Authors: Liu Yulan , Xie Wenjie , Meng Yang , Sun Lifang , Yan Juanjuan , Dong Weiguo , Zhou Chenliang , Yu Zhui
Published: April 2021

The coronavirus disease (COVID-19) outbreak was first reported in December 2019 in Wuhan, China. Specific information about critically ill COVID-19 patients receiving invasive mechanical ventilation (IMV) is rare.

To describe the clinical course and complications of critically ill patients with COVID-19 who received IMV and were successfully weaned from it.

This retrospective study included patients admitted to 3 intensive care units (ICUs) and 1 sub-ICU of Renmin Hospital of Wuhan University and Wuhan Jin Yin-tan Hospital between December 24, 2019, and March 12, 2020. Eleven patients who had been diagnosed with critically ill COVID-19 according to the World Health Organization interim guidance, received invasive ventilation, and were finally successfully weaned from it, were enrolled in our study. Their presenting symptoms, comorbidity conditions, laboratory values, ICU course, ventilator parameters, treatments, and relative complications were recorded.

Of 108 critically ill COVID-19 patients who received invasive ventilation, 11 patients who underwent tracheal extubation or terminal weaning were included. The mean age of the 11 patients was 52.8 years (range, 38–70 years), 8 (72.7%) were male, and 2 were health care workers. The median time from onset of symptoms to dyspnea was 6.6 days (range, 3–13 days), and the median duration of IMV was 15.7 days (range, 6–29 days). All 11 patients presented with acute severe hypoxemic respiratory failure and received IMV, and 1 patient switched to extracorporeal membrane oxygenation assistance. A lung-protective strategy with lower tidal volume ventilation and proper driving pressure is the main strategy of IMV. All patients had extrapulmonary manifestations, including acute kidney injury, hepatic dysfunction, myocardial damage, and/or lymphopenia. Hospital-acquired infections occurred in 7 (63.6%) patients.

Critical COVID-19 illness is characterized by acute hypoxemic respiratory failure and subsequent dysfunction of other organs with a high mortality rate. Correct ventilation strategies and other clinical strategies to improve oxygenation based on the skilled trained group and the availability of equipment are the key methods to rescue lives.
Differences in microbiota between acute and chronic perianal eczema
Authors: Ma Ming , Lu Hongmei , Yang Zuozhen , Chen Li , Li Yingru , Zhang Xiu
Published: April 2021

Microbiota has been suggested to play a role in patients with intestinal and cutaneous diseases. However, the profiling of perianal eczema microbiota has not been described. We have explored the general profile and possible differences between acute and chronic perianal eczema. A total of 101 acute perianal eczema (APE) and 156 chronic perianal eczema (CPE) patients were enrolled in this study and the perianal microbiota was profiled via Illumina sequencing of the 16S rRNA V4 region.

The microbial α-diversity and structure are similar in APE and CPE patients; however, the perianal microbiota of the APE patients had a higher content of Staphylococcus (22.2%, P < .01) than that of CPE patients. Top10 genera accounting for more than 60% (68.81% for APE and 65.47% for CPE) of the whole microbiota, including Prevotella, Streptococcus, and Bifidobacterium, show an upregulation trend in the case of APE without reaching statistically significant differences. This study compared the microbiota profiles of acute and chronic perianal eczema. Our results suggest that the microbiota of acute perianal eczema patients is enriched in Staphylococcus compared with that in the chronic group. Our findings provide data for further studies.
Research on medical system based on blockchain technology
Authors: Jia Qu
Published: April 2021

Medical data sharing, anti-tampering, and leakage prevention have always been severe problems that plagued the pharmaceutical industry. When a patient is referred, he often cannot provide information about previous visits because the medical information of each hospital cannot be shared in most cases, but only through Medical records, test sheets, and other easily lost paper information are used to share some medical information. At the same time, patient medical information is easily leaked, and the medical information provided in the event of a medical dispute cannot guarantee authenticity and impartiality. This article designs a consortium medical blockchain system based on a Possible Byzantine Fault Tolerance algorithm. This system is a medical system that is maintained and shared by multiple nodes and can prevent medical data from being tampered with or leaked. It can be used to solve these medical problems. Compared with the existing medical blockchain system, this system has certain advantages and better applicability.
Presentation and management of nasal foreign bodies in a Chinese metro area
Authors: Yan Shang , Zeng Nan , Chen Guowei , Chen Yongchao , Wu Zebin , Pan Hongguang , Teng Yishu , Ma Xiangyu , Li Lan
Published: April 2021

Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.

Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children's Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.

Nasal foreign bodies were common in children between 1 and 5 years of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1 day. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.

The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.
Alteration of brain connectivity in neurologically asymptomatic patients with chronic kidney disease
Authors: Lee Yoo Jin , Yoon Eunjae , Park Sihyung , Kim Yang Wook , Kim Si Eun , Ko Junghae , Park Jin Han , Park Kang Min , Kim Il Hwan , Park Bong Soo
Published: April 2021

Our previous study demonstrated that patients with end-stage renal disease had decreased structural and functional brain connectivity, and there was a significant association between brain connectivity and cognitive function. The aim of this study was to evaluate the alterations of structural and functional connectivity using graph theoretical analysis in neurologically asymptomatic patients with relatively early-stage chronic kidney disease (CKD).

We enrolled 18 neurologically asymptomatic patients with early CKD and 28 healthy controls. All the subjects underwent diffusion-tension imaging and resting functional magnetic resonance imaging. We calculated structural and functional connectivity based on diffusion-tension imaging and resting functional magnetic resonance imaging using a graph theoretical analysis. Then, we investigated differences of structural and functional connectivity between the CKD patients and the healthy controls.

All the measures of structural connectivity were significantly different between the patients with CKD and healthy controls. The global efficiency, local efficiency, mean clustering coefficient, and small-worldness index were decreased, whereas the characteristic path length was increased in the patients with CKD compared with healthy controls. The structural betweenness centrality of the left calcarine and right posterior cingulum was also significantly different from that in healthy participants. However, all the measures of global functional connectivity in patients with CKD were not different from those in healthy controls. In patients with CKD, the functional betweenness centrality of the right insular cortex, right occipital pole, and right thalamus was significantly different from that in healthy participants.

There are significant alterations of the global structural connectivity between the patients with CKD and the healthy subjects, whereas the global functional connectivity of the brain network is preserved. We find that the efficiency of the structural brain network is decreased in the patients with CKD.
Evaluation of a deep learning-based computer-aided detection algorithm on chest radiographs
Authors: Choi Soo Yun , Park Sunggyun , Kim Minchul , Park Jongchan , Choi Ye Ra , Jin Kwang Nam
Published: April 2021

Along with recent developments in deep learning techniques, computer-aided diagnosis (CAD) has been growing rapidly in the medical imaging field. In this work, we evaluate the deep learning-based CAD algorithm (DCAD) for detecting and localizing 3 major thoracic abnormalities visible on chest radiographs (CR) and to compare the performance of physicians with and without the assistance of the algorithm. A subset of 244 subjects (60% abnormal CRs) was evaluated. Abnormal findings included mass/nodules (55%), consolidation (21%), and pneumothorax (24%). Observer performance tests were conducted to assess whether the performance of physicians could be enhanced with the algorithm. The area under the receiver operating characteristic (ROC) curve (AUC) and the area under the jackknife alternative free-response ROC (JAFROC) were measured to evaluate the performance of the algorithm and physicians in image classification and lesion detection, respectively. The AUCs for nodule/mass, consolidation, and pneumothorax were 0.9883, 1.000, and 0.9997, respectively. For the image classification, the overall AUC of the pooled physicians was 0.8679 without DCAD and 0.9112 with DCAD. Regarding lesion detection, the pooled observers exhibited a weighted JAFROC figure of merit (FOM) of 0.8426 without DCAD and 0.9112 with DCAD. DCAD for CRs could enhance physicians’ performance in the detection of 3 major thoracic abnormalities.
Loneliness and Current Environmental Context Are Associated With False Perceptions Regarding Social Relations
Authors: Reed Phil , Tshering Sherlyn , Wahab Siti
Published: April 2021

The consequences of loneliness include anxiety, depression, and chronic illnesses, but little is known about its association with cognitive distortions. Three experiments investigated the effect of loneliness, and current context, on the content of false perceptions. A total of 446 participants completed psychometric tests (University of California, Los Angeles Loneliness Scale, Hospital Anxiety and Depression Scale, and a Schizotypy Scale) and a word detection task. The word detection task explored the effects of “lonely” and “neutral” contexts (experiments 1 and 2), as well as “positive social” contexts (experiment 3), on false perceptions. In all experiments, participants reporting higher loneliness reported more false perceptions with a lonely content, but only when in a context reflecting a lonely theme. The results show current environmental context and individuals' psychological state combine to affect false perception content. That such findings are found with loneliness, when controlling for depression, anxiety, and schizotypy, show the degree to which this state can distort cognition and perception.
Why Nursing Research Matters
Authors: Lal M. Maureen
Published: April 2021

Increasingly, nursing research is considered essential to the achievement of high-quality patient care and outcomes. In this month's Magnet® Perspectives column, we examine the origins of nursing research, its role in creating the Magnet Recognition Program®, and why a culture of clinical inquiry matters for nurses. This column explores how Magnet hospitals have built upon the foundation of seminal research to advance contemporary standards that address some of the challenges faced by healthcare organizations around the world. We offer strategies for nursing leaders to develop robust research-oriented programs in their organizations.
Implementation Science and Nursing Leadership: Improving the Adoption and Sustainability of Evidence-Based Practice
Authors: Nelson-Brantley Heather V. , Chipps Esther
Published: April 2021

Increasingly, nurse executives are embracing evidence-based practice (EBP). Yet, it takes 17 years to move only 14% of research evidence into practice. Implementation science (IS) aims to reduce this gap through the study of factors that influence dissemination, adoption, implementation, and sustainability of evidence-based interventions. Nurse leaders aiming for EBP must be well equipped to support IS. This article introduces IS, leadership competencies essential for supporting implementation research and practice, and preparing an IS-ready workforce.
Timing of Diagnosis of Complex Lower Urinary Tract Injury in the 30-Day Postoperative Period Following Benign Hysterectomy
Authors: Luchristt Douglas , Brown Oluwateniola , Geynisman-Tan Julia , Mueller Margaret G. , Kenton Kimberly , Bretschneider C. Emi
Published: April 2021

(Abstracted from Am J Obstet Gynecol 2020; doi: 10.1016/j.ajog.2020.10.050)

Complex lower urinary tract injury (cLUTI) resulting from hysterectomy is a rare but potentially devastating complication. A number of risk factors for cLUTI at the time of hysterectomy have been identified.
The Association of Maternal Hypertensive Disorders With Neonatal Congenital Heart Disease: Analysis of a United States Cohort
Authors: Sanapo Laura , Donofrio Mary T. , Ahmadzia Homa K. , Gimovsky Alexis C. , Mohamed Mohamed A.
Published: April 2021

(Abstracted from J Perinatol 2020;40(11):1617–1624)

One of the more common causes of maternal and perinatal mortality is hypertensive disorders of pregnancy (HDPs). Hypertension affects up to 10% of pregnancies and has been associated with an increased risk of congenital heart disease (CHD) in offspring.
SARS-CoV-2 in First Trimester Pregnancy: A Cohort Study
Authors: la Cour Freiesleben N. , Egerup P. , Hviid K. V. R. , Severinsen E. R. , Kolte A. M. , Westergaard D. , Olsen L. Fich , Prætorius L. , Zedeler A. , Christiansen A.-M. H. , Nielsen J. R. , Bang D. , Berntsen S. , Ollé-López J. , Ingham A. , Bello-Rodríguez J. , Storm D. M. , Ethelberg-Findsen J. , Hoffmann E. R. , Wilken-Jensen C. , Jørgensen F. S. , Westh H. , Jørgensen H. L. , Nielsen H. S.
Published: April 2021

(Abstracted from Hum Reprod 2021;36(1):40–47)

Pregnant women are at an increased risk of viral infections and increased risk of serious morbidity such as severe pneumonia, particularly during the first trimester. COVID-19 (coronavirus disease 2019) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Bowhead whales overwinter in the Amundsen Gulf and Eastern Beaufort Sea
Authors: Insley S. J. , Halliday W. D. , Mouy X. , Diogou N.
Published: April 2021

The bowhead whale is the only baleen whale endemic to the Arctic and is well adapted to this environment. Bowheads live near the polar ice edge for much of the year and although sea ice dynamics are not the only driver of their annual migratory movements, it likely plays a key role. Given the intrinsic variability of open water and ice, one might expect bowhead migratory plasticity to be high and linked to this proximate environmental factor. Here, through a network of underwater passive acoustic recorders, we document the first known occurrence of bowheads overwintering in what is normally their summer foraging grounds in the Amundsen Gulf and eastern Beaufort Sea. The underlying question is whether this is the leading edge of a phenological shift in a species' migratory behaviour in an environment undergoing dramatic shifts due to climate change.
The ecological, genetic and genomic architecture of local adaptation and population differentiation inBoechera stricta
Authors: Lin Ya-Ping , Mitchell-Olds Thomas , Lee Cheng-Ruei
Published: April 2021

Differential local adaptation restricts gene flow between populations inhabiting distinct environments, resulting in isolation by adaptation. In addition to the statistical inferences of genotype–environment associations, an integrative approach is needed to investigate the effect of local adaptation on population divergence at the ecological, genetic and genomic scale. Here, we combine reciprocal transplant, genome–environment association and QTL mapping to investigate local adaptation inBoechera stricta(Drummond's rockcress). With reciprocal transplant experiment, we found local genetic groups exhibit phenotypic characteristics corresponding to the distinct selection forces from different water availability. At the genetic level, the local allele of a major fitness QTL confers higher and sturdier flowering stalks, maximizing the fecundity fitness component under sufficient water supply, and its genetic variation is associated with precipitation across the landscape. At the genomewide scale, we further showed that multiple loci associated with precipitation are highly differentiated between genetic groups, suggesting that local adaptation has a widespread effect on reducing gene flow. This study provides one of the few comprehensive examples demonstrating how local adaptation facilitates population divergence at the trait, gene and genome level.
Locomotor transitions in the potential energy landscape-dominated regime
Authors: Othayoth Ratan , Xuan Qihan , Wang Yaqing , Li Chen
Published: April 2021

To traverse complex three-dimensional terrain with large obstacles, animals and robots must transition across different modes. However, most mechanistic understanding of terrestrial locomotion concerns how to generate and stabilize near-steady-state, single-mode locomotion (e.g. walk, run). We know little about how to use physical interaction to make robust locomotor transitions. Here, we review our progress towards filling this gap by discovering terradynamic principles of multi-legged locomotor transitions, using simplified model systems representing distinct challenges in complex three-dimensional terrain. Remarkably, general physical principles emerge across diverse model systems, by modelling locomotor–terrain interaction using a potential energy landscape approach. The animal and robots' stereotyped locomotor modes are constrained by physical interaction. Locomotor transitions are stochastic, destabilizing, barrier-crossing transitions on the landscape. They can be induced by feed-forward self-propulsion and are facilitated by feedback-controlled active adjustment. General physical principles and strategies from our systematic studies already advanced robot performance in simple model systems. Efforts remain to better understand the intelligence aspect of locomotor transitions and how to compose larger-scale potential energy landscapes of complex three-dimensional terrains from simple landscapes of abstracted challenges. This will elucidate how the neuromechanical control system mediates physical interaction to generate multi-pathway locomotor transitions and lead to advancements in biology, physics, robotics and dynamical systems theory.
The sensory impacts of climate change: bathymetric shifts and visually mediated interactions in aquatic species
Authors: Caves Eleanor M. , Johnsen Sönke
Published: April 2021

Visual perception is, in part, a function of the ambient illumination spectrum. In aquatic environments, illumination depends upon the water's optical properties and depth, both of which can change due to anthropogenic impacts: turbidity is increasing in many aquatic habitats, and many species have shifted deeper in response to warming surface waters (known as bathymetric shifts). Although increasing turbidity and bathymetric shifts can result in similarly large changes to a species' optical environment, no studies have yet examined the impact of the latter on visually mediated interactions. Here, we examine a potential link between climate change and visual perception, with a focus on colour. We discuss (i) what is known about bathymetric shifts; (ii) how the impacts of bathymetric shifts on visual interactions may be distributed across species; (iii) which interactions might be affected; and (iv) the ways that animals have to respond to these changes. As warming continues and temperature fluctuations grow more extreme, many species may move into even deeper waters. There is thus a need for studies that examine how such shifts can affect an organism's visual world, interfere with behaviour, and impact fitness, population dynamics, and community structure.
Elevated circulating CD16+ monocytes and TLR4+ monocytes in older adults with multiple cardiometabolic disease risk factors: A cross-sectional analysis
Authors: Markofski Melissa M. , Flynn Michael G.
Published: April 2021

We endeavored to examine relationships between circulating monocyte phenotype and cardio-metabolic disease risk, in healthy, older adults. We performed a secondary data analysis on men and women, 55-75 yr, who were assigned to groups based on cardio-metabolic risk factors other than age. Subject in the low risk group (n=16, 12 females) had fewer than three risk factors. Subjects in the elevated risk group (n=29, 19 females) had three or more risk factors. Along with baseline screening for fitness and body composition, resting blood samples were assessed for markers of inflammation including: monocyte phenotype (inflammatory monocytes), monocyte cell-surface TLR4 expression, and serum C-reactive protein. The low risk group had a smaller (19.3% difference; p<0.0001) waist circumference and lower body fat weight (36.3%; p<0.0001), but higher max (45.5%; p=0.0019). There were no mean differences (p>0.05) between the low and elevated risk groups for BMI, serum cholesterol, fasting glucose, or leg press 1RM. The low risk group had lower CRP (114.7%, p=0.0002), higher CD14+CD16- (classical) monocytes (6.7%; p=0.0231) and fewer CD14+CD16+ (inflammatory) monocytes (46.2%; p=0.0243) than the elevated risk group. The low risk group also had a lower percentage of CD14+CD16+ monocytes that were positive for TLR4 (14.0%; p=0.0328). Older men and women with fewer cardio-metabolic risk factors had lower serum and cellular markers of inflammation and higher aerobic capacity.
A survey of clinical opinions and preferences on the non-surgical management of intermittent exotropia in China
Authors: Wu Yidong , Peng Tingting , Zhou Jinjing , Xu Meiping , Gao Yi , Zhou Jiawei , Hou Fang , Yu Xinping
Published: April 2021

Purpose

Intermittent exotropia (IXT) is the most common form of childhood exotropia. Currently, controversies exist regarding its management and non-surgical options in particular. This study reports clinical opinions and preferences on the non-surgical management among practitioners in China. The opinions within and between ophthalmologists and optometrists were also compared.

Design

Cross-sectional survey study.

Methods

An online survey was developed and distributed through professional bodies. The study was conducted from July 25th to August 3rd, 2019. A total of 300 ophthalmologists and 188 optometrists responded.

Results

Of 488 participants, 257 (53%) considered fusion defects as the main cause of IXT, and 299 (61%) took IXT as a progressive disorder. Two hundred and seventy-one (56%) participants considered orthoptic exercises as the most effective non-surgical intervention for IXT. Likewise, 245 (50%) participants reported that orthoptic exercises was their most frequent non-surgical option, followed by observation (178, 37%). There are discrepancies between ophthalmologists and optometrists. A greater proportion of ophthalmologists (201, 67%) shared the view that IXT worsens over time compared with optometrists (98, 52%) (p = 0.001). Additionally, ophthalmologists (121, 40%) tended to prefer observation compared with optometrists (57, 30%) (p = 0.021).

Conclusions

This study shows that there is no general consensus on the non-surgical management of IXT in China. Given the lack of robust evidence, the findings from this study not only show the current clinical opinions but also highlight the need for future randomized clinical trials to validate the effectiveness of non-surgical interventions, orthoptic exercises in particular, and to establish treatment guidelines accordingly.
Latent subtypes of manic or irritable episode symptoms in two population-based cohorts
Authors: Arathimos Ryan , Fabbri Chiara , Vassos Evangelos , Davis Katrina A S , Pain Oliver , Gillett Alexandra , Coleman Jonathan R I , Hanscombe Ken , Hagenaars Saskia , Jermy Bradley , Corbett Anne , Ballard Clive , Aarsland Dag , Creese Byron , Lewis Cathryn M
Published: April 2021

Background

Episodic changes in mood characterise disorders such as bipolar disorder, which includes distinct periods of manic excitability or irritability, along with additional symptoms experienced during these periods. Common clinical understanding informs diagnostic criteria and epidemiological studies reflect clinical thresholds.

Aims

To use a data-driven approach to defining groupings of symptoms experienced during periods of manic or irritable mood, which could inform understanding of mood disorders and guide case classification by identifying subgroups with homogeneous clinical/functional outcomes.

Methods

We used latent class analysis (LCA) to conduct an exploration of the latent structure in symptom responses in the UK Biobank and PROTECT studies, by investigating how symptoms, experienced during periods of manic or irritable mood, formed latent subgroups. We tested associations of latent subgroups with sociodemographic characteristics, diagnoses of psychiatric disorders and polygenic risk scores (PRS).

Results

Five latent classes were identified that captured patterns of symptoms experienced during periods of manic or irritable mood (N=42,183) in UK Biobank. We identified one class that experienced disruptive episodes of mostly irritable mood that was largely comprised of cases of depression/anxiety, and a class of individuals with increased confidence/creativity that reported lower disruptiveness and lower functional impairment. The five latent classes were replicated in an independent cohort, the PROTECT study (N=4,445), with similar distinctions between classes.

Conclusion

Our data-driven approach to grouping individuals identified distinct latent classes. A dimensional classification of mood disorders informed by our findings will be able to better assess or subtype these disorders in future studies.
UK Health Care Workers’ Experiences of Major System Change in Elective Surgery during the COVID-19 Pandemic: Reflections on Rapid Service Adaptation
Authors: Singleton Georgina , Dowrick Anna , Manby Louisa , Fillmore Harrison , Syverson Aron , Lewis-Jackson Sasha , Uddin Inayah , Sumray Kirsi , Bautista-González Elysse , Johnson Ginger , Vindrola-Padros Cecilia
Published: April 2021

Background

The COVID-19 pandemic disrupted the delivery of elective surgery in the UK. The majority of planned surgery was cancelled or postponed in March 2020 for the duration of the first wave of the pandemic. We investigated the experiences of staff responsible for delivering rapid changes to surgical services during the first wave of the pandemic in the UK, with the aim of developing lessons for future major systems change.

Methods

Using a rapid qualitative study design, we conducted 25 interviews with frontline surgical staff during the first wave of the pandemic. We also carried out a policy review of the guidance developed for those delivering surgical services in pandemic conditions. We used framework analysis to organise and interpret findings.

Results

Staff discussed positive and negative experiences of rapid service organisation. Clinician-led decision making, the flexibility of individual staff and teams, and the opportunity to innovate service design were all seen as positive contributors to success in service adaptation. The negative aspects of rapid change were inconsistent guidance from national government and medical bodies, top-down decisions about when to cancel and restart surgery, the challenges of delivering emergency surgical care safely and the complexity of prioritising surgical cases when services re-started.

Conclusion

Success in the rapid reorganisation of elective surgical services can be attributed to the flexibility and adaptability of staff. However, there was an absence of involvement of staff in wider system-level pandemic decision-making and competing guidance from national bodies. Involving staff in decisions about the organisation and delivery of major systems change is essential for the sustainability of change processes.
Policies for Easing COVID-19 Pandemic Travel Restrictions
Authors: Le Thien-Minh , Raynal Louis , Talbot Octavious , Hambridge Hali , Drovandi Christopher , Mira Antonietta , Mengersen Kerrie , Onnela Jukka-Pekka
Published: April 2021

During the COVID-19 pandemic, many countries implemented international travel restrictions that aimed to contain viral spread while still allowing necessary cross-border travel for social and economic reasons. The relative effectiveness of these approaches for controlling the pandemic has gone largely unstudied. Here we developed a flexible network meta-population model to compare the effectiveness of international travel policies, with a focus on evaluating the benefit of policy coordination. Because country-level epidemiological parameters are unknown, they need to be estimated from data; we accomplished this using approximate Bayesian computation, given the nature of our complex stochastic disease transmission model. Based on simulation and theoretical insights we find that, under our proposed policy, international airline travel may resume up to 58% of the pre-pandemic level with pandemic control comparable to that of a complete shutdown of all airline travel. Our results demonstrate that global coordination is necessary to allow for maximum travel with minimum effect on viral spread.
Two Stage Hierarchical Group Testing Strategy to Increase SARS-CoV-2 Testing Capacity at an Institution of Higher Education: A Retrospective Analysis
Authors: Ganz Troy , Waithe-Alleyne Markus , Slate Deirdre , Donner Rachel , Hines Kevin , Abel Gyorgy , Auclair Jared
Published: April 2021

Population testing for severe acute respiratory syndrome 2 (SAR-CoV-2) is necessary owing to the possibility of viral transmission from asymptomatic cases, yet scarcity of reagents and equipment has added to the cost-prohibitive implementation of screening campaigns at institutions of higher education. The high analytical sensitivities of leading nucleic acid amplification diagnostic methods allow for group testing to increase testing capacity. A feasibility study was performed using an optimized testing configuration model for pooling three, five, and ten samples. Following the standard RNA extraction and purification workflow for quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) method using Thermo Fisher TaqPath™ COVID-19 multiplex primers and probes for the ORF1ab, N, and S genes, matrix and dilution effects were assessed using pooled negative samples as the diluent. Probit analysis produced a limit of detection of 16075 (ORF1ab), 1308 (N), and 1180182 (S) genomic copy equivalents per milliliter. Trials comparing neat to 1:5 dilution for 34 weak-to-strongly positive samples demonstrated average threshold cycle (CT) shifts of 2.31±1.16 (ORF1ab), 2.23±1.12 (N), and 2.79±1.40 (S). Notwithstanding observed S gene dropouts, the false negative rate was unaffected. As the ratio of asymptomatic positive to symptomatic positive SARS-CoV-2 infected individuals was approximately 4:1 and the average prevalence was 0.16% since we started testing in August 2020, pooled testing was identified as a viable, cost-effective option for monitoring the Northeastern University community.
Engagement in leisure activities and depression in older adults in the United States: Longitudinal evidence from the Health and Retirement Study
Authors: Bone Jessica K , Bu Feifei , Fluharty Meg , Paul Elise , Sonke Jill K , Fancourt Daisy
Published: April 2021

Objectives

Receptive cultural engagement (e.g., attending theaters and museums) can reduce depression in older adults. However, whether specific participatory leisure activities are associated with lower rates of depression remains unknown. We aimed to test whether engagement in a diverse range of leisure activities, all of which could involve artistic or creative elements, was associated with concurrent and subsequent depression.

Methods

Using longitudinal data from 19,134 participants aged over 50 in the Health and Retirement Study, engagement in leisure activities was measured every four years, and depression every two years, between 2008 and 2016. Leisure activities included: reading books, magazines, or newspapers; writing; baking/cooking something special; making clothes, knitting, or embroidery (sewing); working on hobbies/projects; going to sport, social, or other clubs; and attending non-religious organization meetings. A score of three or more on the Center for Epidemiologic Studies Depression Scale indicated depression. We fitted population-averaged panel data models using generalized estimating equations with a logit link.

Results

Engaging in some leisure activities, such as clubs, hobbies/projects, and baking/cooking was associated with reduced depression, independent of confounders. Concurrently, spending time on hobbies/projects (monthly OR = 0.80, 95% CI = 0.72–0.88; weekly OR = 0.81, 95% CI = 0.73–0.89) and clubs (monthly OR = 0.85, 95% CI = 0.77–0.94; weekly OR = 0.78, 95% CI = 0.69–0.88) was associated with lower odds of depression versus not engaging. Longitudinally, the odds of depression two years later were reduced amongst people engaging in weekly baking/cooking (OR = 0.85, 95% CI = 0.75– 0.95), hobbies (OR = 0.81, 95% CI = 0.71–0.92), and clubs (OR = 0.82, 95% CI = 0.71–0.94). Writing, reading, sewing, and attending non-religious organizations were not consistently associated with depression.

Discussion

Engagement in some leisure activities is associated with reduced odds of depression. We should consider how older adults can be supported to actively participate in leisure activities as health-promoting behaviors.
Seroprevalence of hepatitis A and hepatitis E viruses among pregnant women in Northern Iran
Authors: Sadeghi Farzin , Golchob Zahra , Javadian Maryam , Barary Mohammad , Sabbagh Parisa , Ebrahimpour Soheil , Bayani Masoumeh
Published: April 2021

Background

Hepatitis A (HAV) and Hepatitis E viruses (HEV) are endemic in Iran and are known major causes of acute viral hepatitis. Also, during pregnancy, they are associated with severe outcomes. Therefore, it is vital to evaluate the antibody levels against HAV and HEV in pregnant women to avoid severe outcomes incidence.

Study design and methods

A total of 247 pregnant women were enrolled in this prospective cross-sectional study. In addition to completing the questionnaire and interviewing all participants, the serum samples were tested for anti-HAV and anti-HEV IgG using the enzyme-linked immunosorbent assay (ELISA). The association between anti-HAV and anti-HEV antibodies status and risk factors was evaluated.

Results

The mean age of patients was 28.06 ± 5.29 years. Anti-HAV antibody was found in 111 patients (44.9%), while anti-HEV antibody was detected in only two pregnant women (0.8%). The seroprevalence of HAV was inversely related to the level of education. There was no significant correlation between HAV antibody levels and age, marital status, residence location, and pregnancy trimesters.

Conclusion

Considering many complications of these diseases in pregnancy, the detection of enteroviral hepatitis, especially HAV in pregnant women, is necessary, and therefore, proactive measures, such as promoting education, improving people awareness, and vaccination, are recommended
Evaluation of seven different rapid methods for nucleic acid detection of SARS-COV-2 virus
Authors: Mahmoud Sally A. , Ibrahim Esra , Ganesan Subhashini , Thakre Bhagyashree , Teddy Juliet George , Raheja Preeti , Zaher Walid Abbas
Published: April 2021

Background

In the current COVID-19 pandemic there is mass screening of SARS-CoV-2 happening round the world due to the extensive spread of the infections. There is a high demand for rapid diagnostic tests to expedite identification of cases and to facilitate early isolation and control spread. Hence this study evaluates seven different rapid nucleic acid detection assays that are commercially available for SARS-CoV-2 virus detection.

Methods

Nasopharyngeal samples were collected from 4859 participants and were tested for SARS-CoV-2 virus by the gold standard RT-PCR method along with one of these seven rapid methods of detection. Evaluation of the rapid nucleic acid detection assays was done by comparing the results of these rapid methods with the gold standard RT-qPCR results for SARS-COV-2 detection.

Results

AQ-TOP had the highest sensitivity (98%) and strong kappa value of 0.943 followed by Genechecker and Abbot ID NOW. The POCKIT (ii RT-PCR) assay had the highest test accuracy of 99.29% followed by Genechecker and Cobas Liat. Atila iAMP showed the highest percentage of invalid reports (35.5%) followed by AQ-TOP with 6% and POCKIT with 3.7% of invalid reports.

Conclusion

Genechecker system, Abbott ID NOW and Cobas Liat, were found to have best performance and agreement when compared to the standard RT-PCR for COVID-19 detection. With further research, these rapid tests have the potential to be employed in large scale screening of COVID-19.
Contracting COVID-19: A Longitudinal Investigation of the Impact of Beliefs and Knowledge
Authors: Moore Courtney A. , Ruisch Benjamin C. , Samayoa Javier A. Granados , Boggs Shelby T. , Ladanyi Jesse T. , Fazio Russell H.
Published: April 2021

Recent work has found that an individual’s beliefs and personal characteristics can impact perceptions of and responses to the COVID-19 pandemic. Certain individuals—such as those who are politically conservative, endorse conspiracy theories, or who believe the threat of COVID-19 to be exaggerated—are less likely to engage in such preventative behaviors as social distancing. The current research aims to address whether these individual difference variables not only affect people’s subjective and behavioral reactions to the pandemic, but also whether they actually impact individuals’ likelihood of contracting COVID-19. In the early months of the pandemic, U.S. participants responded to a variety of individual difference measures as well as questions specific to COVID-19 and the pandemic itself. Four months later, 2,120 of these participants responded with whether they had contracted COVID-19. Nearly all of our included individual difference measures significantly predicted whether a person reported believing they had contracted COVID-19 as well as whether they had actually tested positive for the virus in this four-month period. Additional analyses revealed that all of these relationships were primarily mediated by whether participants held accurate knowledge about COVID-19. These findings offer useful insights for developing more effective interventions aimed at slowing the spread of both COVID-19 and future diseases. Moreover, some findings offer critical tests of the validity of such theoretical frameworks as those concerning conspiratorial ideation and disgust sensitivity within a real-world context.
Vaccines, social measures and Covid19 - A European evidence-based analysis Vaccines, social measures and Covid19
Authors: Porter John R
Published: April 2021

Background

A fully quantitative picture of national effectiveness in controlling the spread of the Covid19 virus should consider the percentage of a population vaccinated in relation to the percentage of a population as active cases.

Methods

Publicly available data from 27 European countries on nine dates in 2021. Data were (i) initial Covid19 vaccinations and (ii) Covid19 active cases, both as percentages of a country’s population. Dividing (i) by (ii) yielded a new metric, the V ratio, which can increase as (i) increase or as (ii) decreases or both. I correlated the change in V ratio with the change in R statistic in the 27 counties and nine dates.

Results

Mean European V ratio increased from January 11 2021 onwards; inverse correlation was found between V ratio and R statistic (p<0.001, r2=0.15, df=234). Initial threshold V ratio of 10-15 resulted in an R statistic of 1.0 or lower; this threshold increased to 30-40 with further vaccinations. Variation between countries in the V ratio increased with time.

Conclusion

This quantitative assessment and use of a summary data-derived threshold index showed the integrated effectiveness of vaccinations and social measures for European countries for Covid19. It established a threshold range for an R value of 1 and calculation of the number of vaccinations needed in Europe to reduce the infectivity of the virus to unity. Results can be used to quantify the relation between transmission following vaccination and social measures to control the spread of Covid19.

Summary box

‘What is already known’ in the epidemiology of the Covid19 pandemic in Europe countries is time- and country-based estimates of the R statistic as a measure of infectivity, the percentages of vaccinated persons to reduce infectivity and the number of active cases amenable to social measures. What is not known is how these three parameters interact.

What does this study add’? This study adds by invention an index (V) of percentage vaccinated population divided by percentage active cases. It then examines the corresponding V index in relation to the R statistic. It derives a range threshold V ratio for an R statistic of unity and extends this to suggest the total number of vaccines needed in Europe.

Policy implications

These results will allow policy judgements to be made on the basis of measured evidence, and not just models, of the means to reduce the Covid19 pandemic in Europe. The R statistic captures the development of the pandemic; the V ratio measures the integrated and quantified measures to reduce it. Further development of the analysis could assist in calculating the relative effectiveness of vaccination and social measures linked to a range of values of the V ratio. It can also be used as an alarm call to identify states which, even given 100% vaccination, may not reduce their R statistic below unity.