bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between presenting complaints and clinical outcomes in emergency department patients of different age categories
Authors: Raven Wouter , van den Hoven Elisa M.P. , Gaakeer Menno I. , Ter Avest Ewoud , Sir Ozcan , Lameijer Heleen , Hessels Roger A.P.A. , Reijnen Resi , van Zwet Erik , de Jonge Evert , Nickel Christian H. , de Groot Bas
Published: August 2021

Background and importance

Although aging societies in Western Europe use presenting complaints (PCs) in emergency departments (EDs) triage systems to determine the urgency and severity of the care demand, it is unclear whether their prognostic value is age-dependent.

Objective

To assess the frequency and association of PCs with hospitalization and mortality across age categories.

Methods

An observational multicenter study using all consecutive visits of three EDs in the Netherlands Emergency department Evaluation Database. Patients were stratified by age category (0–18; 19–50; 51–65; 66–80; >80 years), in which the association between PCs and case-mix adjusted hospitalization and mortality was studied using multivariable logistic regression analysis (adjusting for demographics, hospital, disease severity, comorbidity and other PCs)

Results

We included 172  104 ED-visits. The most frequent PCs were ‘extremity problems’ [range across age categories (13.5–40.8%)], ‘feeling unwell’ (9.5–23.4%), ‘abdominal pain’ (6.0–13.9%), ‘dyspnea’ (4.5–13.3%) and ‘chest pain’ (0.6–10.7%). For most PCs, the observed and the case-mix-adjusted odds for hospitalization and mortality increased the higher the age category. The most common PCs with the highest adjusted odds ratios (AORs, 95% CI) for hospitalization were ‘diarrhea and vomiting’ [2.30 (2.02–2.62)] and ‘feeling unwell’ [1.60 (1.48–1.73)]. Low hospitalization risk was found for ‘chest pain’ [0.58 (0.53–0.63)] and ‘palpitations’ [0.64 (0.58–0.71)].

Conclusions

Frequency of PCs in ED patients varies with age, but the same PCs occur in all age categories. For most PCs, (case-mix adjusted) hospitalization and mortality vary across age categories. ‘Chest pain’ and ‘palpitations,’ usually triaged ‘very urgent’, carry a low risk for hospitalization and mortality.
Effectiveness of the modified Valsalva manoeuvre in adults with supraventricular tachycardia: a systematic review and meta-analysis
Authors: Lodewyckx Eric , Bergs Jochen
Published: August 2021

Background and importance

Cardiac arrhythmia, specifically paroxysmal supraventricular tachycardia (SVT), accounts for a substantial proportion of emergency medical services resources utilisation. Reconversion requires increasing the atrioventricular node’s refractoriness, which can be achieved by vagal manoeuvres, pharmacological agents or electrical cardioversion. There are multiple variants of vagal manoeuvres, including the Valsalva manoeuvre (VM). While the effectiveness of the standard VM has already been systematically reviewed, there has been no such analysis for the modified VM.

Objective(s)

Compare the effectiveness of the modified VM versus the standard VM in restoring the normal sinus rhythm in adult patients with supraventricular tachycardia.

Design

Systematic review with meta-analysis of published randomised controlled trials.

Outcome measures

The primary outcome was the reconversion to a sinus rhythm. Secondary outcomes included: medication use, adverse events, length of stay in the emergency department and hospital admission.

Main results

Five randomised controlled trials were included, with a combined total of 1181 participants. The meta-analysis demonstrated a significantly higher success rate for reconversion to sinus rhythm when using the modified VM compared to the standard VM in patients with an SVT (odds ratio = 4.36; 95% confidence interval, 3.30–5.76; P < 0.001). More adverse events were reported in the modified VM group, although this difference is NS (risk ratio = 1.48; 95% confidence interval, 0.91–2.42; P = 0.11). The available evidence suggests that medication use was lower in the modified VM group than the standard VM group. However, medication use could not be generalised across the different studies. None of the included studies showed a significant difference in length of stay in the emergency department. Only one study reported on hospital admission, with no significant difference between the two groups.

Conclusions

The available evidence is highly suggestive to support the use of the modified VM compared to the standard VM in the treatment of adult patients with SVT. Meta-analysis showed a higher success rate, required less medication use, and resulted in an equal number of adverse events. However, these results cannot be regarded as definitive in the absence of higher-quality studies.
Body Composition of Infants With Congenital Gastroschisis
Authors: McNelis Kera , Poindexter Anne , Goddard Gillian , Riddle Stefanie , Wessel Jacqueline , Helmrath Michael
Published: August 2021

Infants born with congenital gastroschisis are at risk for intrauterine growth restriction, small for gestational size at birth, and growth failure during the newborn period despite advanced care. Body composition provides a more complete picture of proportional growth than weight and length alone. Fat‐free mass (FFM) represents organ growth, and in preterm infants without gastroschisis, improved FFM deposition is associated with improved neurodevelopmental outcomes. There is limited literature regarding the body composition of infants with gastroschisis. This case series describes the body composition of 10 infants with gastroschisis.
Outcomes of Traditional and Enhanced Gonorrhea Partner Services in the Strengthening the US Response to Resistant Gonorrhea Project, 2017 to 2019
Authors: Learner Emily R. , Schlanger Karen , Mauk Kerry , Pham Cau D. , Mukai Rachel , Mulleavey Lacy , Kerani Roxanne P. , Albano Terilyn , Sessoms Brandy , Holderman Justin L. , Toro Brian , Sankaran Madeline , Kirkcaldy Robert D. ,   for the SURRG Working Group
Published: August 2021

Introduction

The Centers for Disease Control and Prevention implemented Strengthening the US Response to Resistant Gonorrhea (SURRG) to build local detection and response capacity and evaluate responses to antibiotic-resistant gonorrhea outbreaks, including partner services for gonorrhea. We evaluated outcomes of traditional partner services conducted under SURRG, which involved (1) counseling index patients and eliciting sexual partners; (2) interviewing, testing, and treating partners; and (3) providing partner services to partners newly diagnosed with gonorrhea. We also evaluated outcomes of enhanced partner services, which additionally involved interviewing and testing partners of persons who tested negative, and social contacts of index patients and partners.

Methods

We analyzed partner services investigation data from 8 jurisdictions participating in SURRG from 2017 to 2019. We summed total index patients, partners from traditional partner services, and partners and contacts from enhanced partner services, and calculated partner services outcomes among partners and contacts. We also visualized sexual networks from partner services data.

Results

Of 1242 index patients identified, 506 named at least 1 sexual partner. Traditional partner services yielded 1088 sexual partners, and 105 were newly diagnosed with gonorrhea. Enhanced partner services yielded an additional 59 sexual partners and 52 social contacts. Of those partners and contacts, 3 were newly diagnosed with gonorrhea. Network visualization revealed sparse networks with few complex partnership clusters.

Conclusions

Traditional partner services for gonorrhea may be useful for eliciting, notifying, and diagnosing partners of index patients in an outbreak setting. Enhanced partner services are unlikely to be effective for eliciting, notifying, and diagnosing a substantial number of additional people.
Targeting Culture Criteria to Maximize Culture Positivity of Neisseria gonorrhoeae in 3 Sexual Health Clinic Settings
Authors: Nguyen Trang Quyen , Jamison Kelly , Pfister John , Sankaran Madeline , Amsterdam Lori , Siemetzk-Kapoor Ulrike , Pathela Preeti
Published: August 2021

Background

Although most gonorrhea (GC) cases in the United States are detected using nucleic acid amplification tests (NAATs), isolation of Neisseria gonorrhoeae (NG) using culture specimens is needed for antibiotic susceptibility testing (AST). We present data on NAATs and cultures collected before and during the Centers for Disease Control and Prevention demonstration project (Strengthening the US Response to Resistant Gonorrhea [SURRG]) to describe a process to define culture criteria for NG isolation for surveillance of NG with reduced susceptibility.

Methods

For sexually transmitted infection clinics in New York City, NY; San Francisco, CA; and Milwaukee, WI, we calculated NAAT positivity by anatomic site in 2016 (pre-SURRG) across 3 groups: (1) sex partners of persons with GC, (2) patients with symptoms (e.g., urethral or cervical discharge), (3) patients who had tested positive and were returning for GC treatment and compared it with positivity among all other patients. We then examined SURRG-period NAAT positivity among patients from whom a culture was or was not collected, and culture positivity, by specimen site and jurisdiction.

Results

Pre-SURRG, NAAT positivity across the 3 select groups was at least twice that of patients who did not meet any criteria. SURRG-period NAAT positivity was higher among patients from whom a culture was also collected. Overall culture positivity was relatively high (New York City, 34.8%; San Francisco, 26.7%; Milwaukee, 24.8%); the proportion of specimens tested varied widely (range, 5.7%–26.5%) by jurisdiction.

Conclusions

Evaluation of NAAT data can inform the establishment of criteria for culture collection for AST. Routine evaluation and quality improvement activities related to culture collection/isolation techniques could increase NG isolation for AST.
Trends and Correlates of Age-Disparate Sexual Partnerships in the United States: The National Health and Nutrition Examination Surveys
Authors: White Jodie L. , Patel Eshan U. , Grabowski Mary Kate , Petersen Molly R. , Gaydos Charlotte A. , Quinn Thomas C. , Tobian Aaron A.R.
Published: August 2021

This national survey demonstrates age-disparate (≥5 years; AD-5) sexual partnerships remain common among males and females aged 20 to 29 years in the United States (2005–2016). Females reported more older AD-5 partners, and males reported more younger AD-5 partners. Having AD-5 partners was associated with greater lifetime and recent number of sexual partners.
Supraventricular Tachycardia as the Initial Presentation of New-Onset Lupus
Authors: Rayburn David , Gerke Steven
Published: August 2021

Systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystem disorder that can sometimes be life-threatening. The presentation varies widely given the wide range of clinical and serological manifestations coupled with the disease's ability to affect any organ. Prognosis depends on the organ systems involved, as well as the severity of the involvement. This case involves a 17-year-old with initial presentation of supraventricular tachycardia subsequently found to have pancreatitis, myocarditis, and nephritis secondary to a new diagnosis of SLE. Systemic lupus erythematosus can involve virtually any organ system, which leads to the variable nature of presentation, as was the case for our patient and his presentation being supraventricular tachycardia from underlying myocarditis secondary to SLE. Lupus myocarditis is rare, but when present often indicates severe systemic illness. The echocardiogram will often show global hypokinesis without evidence of coronary artery disease. This was the case with our patient. His echocardiogram demonstrated new-onset systolic left-sided heart failure due to nonischemic cardiomyopathy with an ejection fraction of 25%. Unfortunately for our patient, he had several poor prognostic factors on his initial presentation prior to any treatment being started, including renal disease, male, age (17 years), low socioeconomic status, African American race, and high disease activity. Systemic lupus erythematosus is the great mimicker and can present in a variety of ways. Given its ability to involve virtually any organ system, it is important to consider it on the differential diagnoses, especially in patients with a strong family history.
Review of Reported Adverse Events Occurring Among the Homeless Veteran Population in the Veterans Health Administration
Authors: Soncrant Christina , Mills Peter D. , Pendley Louis Robin P. , Gunnar William
Published: August 2021

Background

United States veterans face an even greater risk of homelessness and associated medical conditions, mental health conditions, and fatal and nonfatal overdose as compared with nonveterans. Beginning 2009, the Department of Veterans Affairs developed a strategy and allocated considerable resources to address veteran homelessness and the medical conditions commonly associated with this condition.

Objective

This study aimed to examine the Veterans Health Administration National Center for Patient Safety database for patient safety events in the homeless veteran population to mitigate future risk and inform policy.

Methods

This was a retrospective, descriptive quality improvement study of reported patient safety events of homeless veterans enrolled in Veterans Health Administration care between January 2012 and August 2020. A validated codebook was used to capture individual patient characteristics, location and type of event, homeless status, and root causes of the events and proposed actions for prevention.

Results

Suicide attempt or death, elopement, delay in care, and unintentional opioid overdose were the most common adverse events reported for this population. Root causes include issues with policies, procedures, and care processes for managing and evaluating homeless patients for the risk of suicidal or overdose behaviors and discharge, poor interdisciplinary communication, and coordination of patient care. Actions included standardization of procedures for discharge, overdose and suicide risk, staff education, and purchasing new equipment.

Conclusions

Suicide and opioid overdose are the most serious reported health care–related adverse events in the unsheltered homeless veteran population. Failures to recognize homelessness status, communicate status, and coordinate available services are root causes of these events.
Modeling the Effects of HIV and Aging on Resting-State Networks Using Machine Learning
Authors: Luckett Patrick H. , Paul Robert H. , Hannon Kayla , Lee John J. , Shimony Joshua S. , Meeker Karin L. , Cooley Sarah A. , Boerwinkle Anna H. , Ances Beau M.
Published: August 2021

Background:

The relationship between HIV infection, the functional organization of the brain, cognitive impairment, and aging remains poorly understood. Understanding disease progression over the life span is vital for the care of people living with HIV (PLWH).

Setting:

Virologically suppressed PLWH (n = 297) on combination antiretroviral therapy and 1509 HIV-uninfected healthy controls were evaluated. PLWH were further classified as cognitively normal (CN) or cognitively impaired (CI) based on neuropsychological testing.

Methods:

Feature selection identified resting-state networks (RSNs) that predicted HIV status and cognitive status within specific age bins (younger than 35 years, 35–55 years, and older than 55 years). Deep learning models generated voxelwise maps of RSNs to identify regional differences.

Results:

Salience (SAL) and parietal memory networks (PMNs) differentiated individuals by HIV status. When comparing controls with PLWH CN, the PMN and SAL had the strongest predictive strength across all ages. When comparing controls with PLWH CI, the SAL, PMN, and frontal parietal network (FPN) were the best predictors. When comparing PLWH CN with PLWH CI, the SAL, FPN, basal ganglia, and ventral attention were the strongest predictors. Only minor variability in predictive strength was observed with aging. Anatomically, differences in RSN topology occurred primarily in the dorsal and rostral lateral prefrontal cortex, cingulate, and caudate.

Conclusion:

Machine learning identified RSNs that classified individuals by HIV status and cognitive status. The PMN and SAL were sensitive for discriminating HIV status, with involvement of FPN occurring with cognitive impairment. Minor differences in RSN predictive strength were observed by age. These results suggest that specific RSNs are affected by HIV, aging, and HIV-associated cognitive impairment.
Appendiceal Neuroendocrine Tumor Detected by 18F-FDG PET/CT
Authors: Zhang Yu , Liu Huipan , Zhang Wei , Chen Yue
Published: August 2021

Appendiceal neuroendocrine tumor is very rare, and it is difficult to make a definite diagnosis before operation due to absence of specific clinical features. We report the 18F-FDG PET/CT findings in a patient with an appendiceal neuroendocrine tumor.
Simulathon 2020
Authors: Thyagarajan Sujatha , Ramachandra Geethanjali , Jamalpuri Vijayanand , Calhoun Aaron W. , Nadkarni Vinay , Deutsch Ellen S. ,   for the Pediatric Simulation Training and Research Society (PediSTARS)
Published: August 2021

Summary Statement

The disaster management cycle is an accepted model that encompasses preparation for and recovery from large-scale disasters. Over the past decade, India's Pediatric Simulation Training and Research Society has developed a national-scale simulation delivery platform, termed the Simulathon, with a period prevalence methodology that integrates with core aspects of this model. As an exemplar of the effectiveness of this approach, we describe the development, implementation, and outcomes of the 2020 Simulathon, conducted from April 20 to May 20 in response to the nascent COVID-19 pandemic disaster. We conclude by discussing how aspects of the COVID-19 Simulathon enabled us to address key aspects of the disaster management cycle, as well as challenges that we encountered. We present a roadmap by which other simulation programs in low- and middle-income countries could enact a similar process.
Manual Conservation of Supplemental Oxygen in Low-Resource Settings During the COVID-19 Pandemic
Authors: Lampotang Samsun , DeStephens Anthony , Zarour Ilana , Lizdas David , Gravenstein Nikolaus , Johnson William , Acar Yahya , Feldman Jeffrey M.
Published: August 2021

Summary Statement

Using a simulated adult COVID-19 patient with hypoxemia, we investigated whether caregivers interrupting oxygen flow by manually occluding oxygen tubing with pliers during exhalation can conserve oxygen while maintaining oxygenation. Oxygen pinching reduced oxygen use by 51% to 64%, maintained simulated oxygen saturation between 88% and 90%, and increased simulated average alveolar partial pressure of oxygen from a room air baseline of approximately 131 to 294–424 mm Hg compared with 607 mm Hg with 10 liters per minute (LPM) continuous oxygen flow. Simulation provided a methodology to rapidly evaluate a technique that has begun to be used with COVID-19 patients in low-resource environments experiencing an acute oxygen shortage.
“Early” Reoperation to Treat Complications Following Laparoscopic Colorectal Surgery: The Sooner the Better
Authors: Rotholtz Nicolas A. , Angeramo Cristian A. , Laporte Mariano , Matzner Perfumo Mariana , Schlottmann Francisco , Bun Maximiliano E.
Published: August 2021

Background:

Some postoperative complications after laparoscopic colorectal surgery (LCS) require reoperation to be treated. However, if the timing to perform this reoperation has some influence on outcome remains elusive. The aim of this study was to analyze if the timing to perform the reoperation has some influence in postoperative outcomes.

Methods:

A retrospective analysis of patients undergoing LCS and required a reoperation during the period 2000 to 2019 were included. The cohort was divided into 2 groups: early reoperation (ER): ≤48 hours or delayed reoperation (DR): ≥48 hours based on the interval between the suspicion of a complication and reoperation. Demographics, operative variables, and postoperative outcomes were compared between groups.

Results:

A total of 1843 LCS were performed, 68 (43%) were included in ER and 91 (57%) in DR. A computed tomography scan was less frequently performed in the ER (ER: 45% vs. DR: 70%; P=0.001). The rates of re-laparoscopy (ER: 86% vs. 73%; P=0.04) and negative findings in the reoperation (ER: 13% vs. DR: 1%, P=0.001) were higher in ER. There were no statistically significant differences in overall major morbidity (ER: 9% vs. DR: 21%; P=0.06) and mortality rate (ER: 4% vs. DR: 8.7%; P=0.28) between groups. The need of intensive care unit was significantly higher and the length of stay longer for patients in the DR group.

Conclusions:

Despite a greater risk of negative findings, ER within 48 hours after the suspicion of a complication after a LCS offers higher chances of using a laparoscopic approach and it could probably provide better postoperative outcomes.
The impact of prehospital time intervals on mortality in moderately and severely injured patients
Authors: Waalwijk Job F. , van der Sluijs Rogier , Lokerman Robin D. , Fiddelers Audrey A.A. , Hietbrink Falco , Leenen Luke P.H. , Poeze Martijn , van Heijl Mark ,   the Pre-hospital Trauma Triage Research Collaborative (PTTRC)
Published: August 2021

BACKGROUND

Modern trauma systems and emergency medical services aim to reduce prehospital time intervals to achieve optimal outcomes. However, current literature remains inconclusive on the relationship between time to definitive treatment and mortality. The aim of this study was to investigate the association between prehospital time and mortality.

METHODS

All moderately and severely injured trauma patients (i.e., patients with an Injury Severity Score of 9 or greater) who were transported from the scene of injury to a trauma center by ground ambulances of the participating emergency medical services between 2015 and 2017 were included. Exposures of interest were total prehospital time, on-scene time, and transport time. Outcomes were 24-hour and 30-day mortality. Generalized linear models including inverse probability weights for several potential confounders were constructed. A generalized additive model was constructed to enable visual inspection of the association.

RESULTS

We included 22,525 moderately and severely injured patients. Twenty-four-hour and 30-day mortality were 1.3% and 7.3%, respectively. On-scene time per minute was significantly associated with 24-hour (relative risk [RR], 1.029; 95% confidence interval, 1.018–1.040) and 30-day mortality (RR, 1.013; 1.008–1.017). We found that this association was also present in patients with severe injuries, traumatic brain injury, severe abdominal injury, and stab or gunshot wound. An on-scene time of 20 minutes or longer demonstrated a strong association with 24-hour (RR, 1.797; 1.406–2.296) and 30-day mortality (RR, 1.298; 1.180–1.428). Total prehospital (24-hour: RR, 0.998; 0.990–1.007; 30-day: RR, 1.000, 0.997–1.004) and transport (24-hour: RR, 0.996; 0.982–1.010; 30-day: RR, 0.995; 0.989–1.001) time were not associated with mortality.

CONCLUSION

A prolonged on-scene time is associated with mortality in moderately and severely injured patients, which suggests that a reduced on-scene time may be favorable for these patients. In addition, transport time was found not to be associated with mortality.

LEVEL OF EVIDENCE

Prognostic and Epidemiologic; level III.
Are rib fractures stable? An analysis of progressive rib fracture offset in the acute trauma setting
Authors: Head William , Kumar Neha , Thomas Christopher , Leon Stuart , Dieffenbaugher Sean , Eriksson Evert
Published: August 2021

BACKGROUND

Rib fractures serve as both a marker of injury severity and a guide for clinical decision making for trauma patients. Although recent studies have suggested that rib fractures are dynamic, the degree of progressive offset remains unknown. The purpose of this study was to further characterize the change that takes place in the acute trauma setting.

METHODS

A 4-year (2016–2019) retrospective assessment of adult trauma patients with rib fracture(s) admitted to a level I trauma center was performed. Initial and follow-up computed tomography scans were analyzed to determine the magnitude of offset. Relevant clinical course variables were examined, and location of chest wall instability was examined using the difference of interquartile range of median change. Statistical Product and Services Solutions (Version 25, IBM Corp. Armonk, NY) was then used to generate a neural network—multilayer perceptron that highlighted independent variable importance.

RESULTS

Fifty-three patients met the inclusion criteria for severe injury. Clinical course variables that either trended or significantly predicted the occurrence of progressive offset were Abbreviated Injury Scale Thoracic Scores (3.1 ± 0.4 no progression vs. 3.4 ± 0.6 yes progression; p = 0.121), flail segment (14% no progression vs. 43% yes progression; p = 0.053), and number of ribs fractured (4 [2–8] no progression vs. 7 [5–9] yes progression; p = 0.023). The location of progressive offset largely corresponded to the posterolateral region as demonstrated by the differences of interquartile range of median change. The neural network demonstrated that ribs 4 to 6 (normalized importance [NI], 100%), the posterolateral region (NI, 87.9%), and multiple fractures per rib (NI, 66.6%) were valuable in predicting whether progressive offset occurred (receiver operating characteristic curve − area under the curve = 0.869).

CONCLUSION

Rib fractures are not stable, particularly for those patients with multiple fractures in the mid-to-upper ribs localized to the posterolateral region. These findings may identify both trauma patients with worse outcomes and help develop better management strategies for rib fractures.

LEVEL OF EVIDENCE

Prognostic and epidemiological, level III.
Pediatric craniocerebral gunshot injuries: A National Trauma Database study
Authors: Lannon Melissa M. , Duda Taylor , Martyniuk Amanda , Engels Paul T. , Sharma Sunjay V.
Published: August 2021

BACKGROUND

We aimed to determine the outcomes and prognostic factors in pediatric craniocerebral gunshot injury (CGI) patients. Pediatric patients may have significantly different physiology, neuroplasticity, and clinical outcomes in CGI than adults. There is limited literature on this topic, mainly case reports and small case series.

METHODS

We queried the National Trauma Data Bank for all pediatric CGI between 2014 and 2017. Patients were identified using International Classification of Diseases, Ninth Revision, codes. Demographic, emergency department, and clinical data were analyzed. Subgroup analysis was attempted for groups with Glasgow Coma Scale (GCS) scores of 9 to 15 and ages 0 to 8 years.

RESULTS

In a 3-year period, there were 209 pediatric patients (aged 0–18 years) presenting to American hospitals with signs of life. The overall mortality rate was 53.11%. A linear relationship was demonstrated showing a mortality rate of 79% by initial GCS in GCS score of 3, 56% in GCS scores of 4 to 8, 22% in GCS scores of 9 to 12, and 5% in GCS scores of 13 to 15. The youngest patients, aged 0 to 8 years, had dramatically better initial GCS and subsequently lower mortality rates. Regression analysis showed mortality benefit in the total population for intracranial pressure monitoring (odds ratio, 0.267) and craniotomy (odds ratio, 0.232).

CONCLUSION

This study uses the National Trauma Data Bank to quantify the prevalence of pediatric intracranial gunshot wounds, with the goal to determine risk factors for prognosis in this patient population. Significant effects on mortality for invasive interventions including intracranial pressure monitoring and craniotomy for all patients suggest low threshold for use of these procedures if there is any clinical concern. The presence of a 79% mortality rate in patients with GCS score of 3 on presentation suggests that as long as there is not a declared neurologic death, intracranial pressure monitoring and treatment measures including craniotomy should be considered by the consulting clinician.

LEVEL OF EVIDENCE

Prognostic and epidemiological, level III.
Inhibition of immunoproteasome subunit low molecular mass polypeptide 7 with ONX-0914 improves hypoxic-ischemic brain damage via PI3K/Akt signaling
Authors: Zhou Yue , Gou Zhixian , Huang Lin , Fan Yang , Zhang Feng , Lu Liqun
Published: August 2021

The immunoproteasome subunit low molecular mass polypeptide 7 (LMP7) leads to brain injuries, such as autoimmune neuritis and ischemic stroke, by activating inflammation. However, the roles and mechanisms of LMP7 in hypoxic-ischemic brain damage (HIBD) remain unclear. This study explored these issues in a rat model of HIBD. Pathology was evaluated using hematoxylin-eosin staining. LMP7 expression was detected using western blot analysis, reverse transcription-quantitative PCR (RT-qPCR), and immunohistochemical staining. The presence of proinflammatory cytokines, including tumor necrosis factor-a, interleukin-6, and interleukin-1β, was tested using ELISA and RT-qPCR. Behavioral performance was evaluated using a short-term neurological function score and the Morris water maze test. Compared to those in the Sham group, the HIBD group exhibited obvious upregulated LMP7 and pro-inflammatory cytokine levels. HIBD rats exhibited severe pathological and behavioral damage. LMP7 inhibition with ONX-0914 reduced proinflammatory cytokine expression, attenuated pathological damage, and enhanced behavioral performance of rats with HIBD. Inhibition of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling with LY29400 increased LMP7 expression and abolished the protective effects of ONX-0914 in HIBD rats. Our findings indicate that LMP7 aggravates brain injury by triggering inflammatory responses in HIBD rats. LMP7 inhibition with ONX-0914 exerts protective effects on HIBD rats, possibly via PI3K/Akt signaling.
The disputed sound of the aurora borealis: sensing liminal noise during the First and Second International Polar Years, 1882–3 and 1932–3
Authors: Amery Fiona
Published: August 2021

This paper discusses heightened interest in the potential audibility of the aurora borealis during the First and Second International Polar Years (IPYs) of 1882–3 and 1932–3. Galvanized by a growing volume of local accounts expressing belief in the elusive noises, written by the inhabitants of the Shetland Islands, northern Canada, and Norway, auroral researchers of each era were determined to establish the objectivity of auroral sound. There was considerable speculation within the auroral research community as to whether the apparent noises were imagined or illusory, connected to discussions about the possibility of low-altitude aurorae. The anglophone auroral sound debate primarily played out within the official reports of IPY expeditions, the journal
Nature
, and a Shetland Island newspaper. I argue that the embodied senses were used exclusively to register the liminal sounds of the aurora across the two periods, despite developments in sound recording technologies, the primacy of mechanical objectivity, and instruments transported to the polar regions for the investigation of visual features of the phenomenon. This overlooked episode complicates narratives of polar science in the late nineteenth and early twentieth centuries by revealing a faith in the corporeal senses and the significant role of amateur observers.
Comparative analysis of stalked and acorn barnacle adhesive proteomes
Authors: Schultzhaus Janna N. , Hervey William Judson , Taitt Chris R. , So Chris R. , Leary Dagmar H. , Wahl Kathryn J. , Spillmann Christopher M.
Published: August 2021

Barnacles interest the scientific community for multiple reasons: their unique evolutionary trajectory, vast diversity and economic impact—as a harvested food source and also as one of the most prolific macroscopic hard biofouling organisms. A common, yet novel, trait among barnacles is adhesion, which has enabled a sessile adult existence and global colonization of the oceans. Barnacle adhesive is primarily composed of proteins, but knowledge of how the adhesive proteome varies across the tree of life is unknown due to a lack of genomic information. Here, we supplement previous mass spectrometry analyses of barnacle adhesive with recently sequenced genomes to compare the adhesive proteomes of
Pollicipes pollicipes
(Pedunculata) and
Amphibalanus amphitrite
(Sessilia). Although both species contain the same broad protein categories, we detail differences that exist between these species. The barnacle-unique cement proteins show the greatest difference between species, although these differences are diminished when amino acid composition and glycosylation potential are considered. By performing an in-depth comparison of the adhesive proteomes of these distantly related barnacle species, we show their similarities and provide a roadmap for future studies examining sequence-specific differences to identify the proteins responsible for functional differences across the barnacle tree of life.
Priming exploration across domains: does search in a spatial environment influence search in a cognitive environment?
Authors: Anvari Farid , Marchiori Davide
Published: August 2021

Is there a general tendency to explore that connects search behaviour across different domains? Although the experimental evidence collected so far suggests an affirmative answer, this fundamental question about human behaviour remains open. A feasible way to test the domain-generality hypothesis is that of testing the so-called priming hypothesis: priming explorative behaviour in one domain should subsequently influence explorative behaviour in another domain. However, only a limited number of studies have experimentally tested this priming hypothesis, and the evidence is mixed. We tested the priming hypothesis in a registered report. We manipulated explorative behaviour in a spatial search task by randomly allocating people to search environments with resources that were either clustered together or dispersedly distributed. We hypothesized that, in a subsequent anagram task, participants who searched in clustered spatial environments would search for words in a more clustered way than participants who searched in the dispersed spatial environments. The pre-registered hypothesis was not supported. An equivalence test showed that the difference between conditions was smaller than the smallest effect size of interest (d= 0.36). Out of several exploratory analyses, we found only one inferential result in favour of priming. We discuss implications of these findings for the theory and propose future tests of the hypothesis.
Jays are sensitive to cognitive illusions
Authors: Schnell Alexandra K. , Loconsole Maria , Garcia-Pelegrin Elias , Wilkins Clive , Clayton Nicola S.
Published: August 2021

Jays hide food caches, steal them from conspecifics and use tactics to minimize cache theft. Jays are sensitive to the content of their own caches, retrieving items depending on their preferences and the perishability of the cached item. Whether jays impose the same content sensitivity when they steal caches is less clear. We adapted the ‘cups-and-balls’ magic routine, creating a cognitive illusion to test whether jays are sensitive to the (i) content of hidden items and (ii) type of displacement. Subjects were presented with two conditions in which hidden food was consistent with their expectations; and two conditions in which food was manipulated to violate their expectations by switching their second preferred food for their preferred food (up-value) or vice versa (de-value). Subjects readily accepted food when it was consistent with their expectations but were more likely to re-inspect the baited cup and alternative cup when their expectations were violated. In the de-value condition, jays exhibited longer latencies to consume the food and often rejected it. Dominant subjects were more likely to reject the food, suggesting that social factors influence their responses to cognitive illusions. Using cognitive illusions offers innovative avenues for investigating the psychological constraints in diverse animal minds.
Contact transfer of engineered nanomaterials in the workplace
Authors: Andreu Irene , Ngo Tuan M. , Perez Viridiana , Bilton Matthew W. , Cadieux Kelly E. C. , Paul Michael T. Y. , Hidalgo Castillo Tania C. , Bright Davies Clifton , Gates Byron D.
Published: August 2021

This study investigates the potential spread of cadmium selenide quantum dots in laboratory environments through contact of gloves with simulated dry spills on laboratory countertops. Secondary transfer of quantum dots from the contaminated gloves to other substrates was initiated by contact of the gloves with different materials found in the laboratory. Transfer of quantum dots to these substrates was qualitatively evaluated by inspection under ultraviolet illumination. This secondary contact resulted in the delivery of quantum dots to all the evaluated substrates. The amount of quantum dots transferred was quantified by elemental analysis. The residue containing quantum dots picked up by the glove was transferred to at least seven additional sections of the pristine substrate through a series of sequential contacts. These results demonstrate the potential for contact transfer as a pathway for spreading nanomaterials throughout the workplace, and that 7-day-old dried spills are susceptible to the propagation of nanomaterials by contact transfer. As research and commercialization of engineered nanomaterials increase worldwide, it is necessary to establish safe practices to protect workers from the potential for chronic exposure to potentially hazardous materials. Similar experimental procedures to those described herein can be adopted by industries or regulatory agencies to guide the development of their nanomaterial safety programmes.
Insights into the aggregation mechanism of RNA recognition motif domains in TDP-43: a theoretical exploration
Authors: Liu Wei , Li Chaoqun , Shan Jiankai , Wang Yan , Chen Guangju
Published: August 2021

The transactive response DNA-binding protein 43 (TDP-43) is associated with several diseases such as amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) due to pathogenic aggregations. In this work, we examined the dimer, tetramer and hexamer models built from the RRM domains of TDP-43 using molecular dynamics simulations in combination with the protein–protein docking. Our results showed that the formations of the dimer models are mainly achieved by the interactions of the RRM1 domains. The parallel β-sheet layers between the RRM1 domains provide most of the binding sites in these oligomer models, and thus play an important role in the aggregation process. The approaching of the parallel β-sheet layers from small oligomer models gradually expand to large ones through the allosteric communication between the α1/α2 helices of the RRM1 domains, which maintains the binding affinities and interactions in the larger oligomer models. Using the repeatable-superimposing method based on the tetramer models, we proposed a new aggregation mechanism of RRM domains in TDP-43, which could well characterize the formation of the large aggregation models with the repeated, helical and rope-like structures. These new insights help to understand the amyloid-like aggregation phenomena of TDP-43 protein in ALS and FTLD diseases.
Sphingobacterium prati sp. nov., isolated from agricultural soil and involved in lignocellulose deconstruction
Authors: Besaury Ludovic , Floret Juliette , Rémond Caroline
Published: August 2021

A bacterial strain, arapr2T, was isolated from agricultural soil sampled in Reims, France. Based on its 16S rRNA gene sequence, the strain was affiliated to the family

Sphingobacteriaceae

and more specifically to the genus

Sphingobacterium

. The strain had 98.31 % 16S rRNA gene sequence similarity to its closest relative

Sphingobacterium canadense

CR11T and 98.25 % to

Sphingobacterium pakistanensis

NCCP-246T. Genome relatedness indexes revealed that the average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values between arapr2T and its closest relative (

S. canadense

CR11T) were 92.97 % and 52.00 %, respectively; for

S. pakistanensis

NCCP-246T, the ANI and dDDH values were 82.46 and 27.6%, respectively. The genomic DNA of strain arapr2T was 6.02 Mbp long, had a DNA G+C content of 40.4 mol% and had 5504 protein-coding genes. The results obtained in this study suggests that strain arapr2T (CIP 111872T=LMG 31848T) represents a new species for which the name Sphingobacterium prati sp. nov. is proposed. Due to the fact that this strain has been isolated using wheat straw as carbon source, this novel bacterial strain represents a promising biotechnological tool for the fractionation of lignocellulosic biomass in the context of biorefinery development.
EXCESS DEATHS FROM ALL CAUSES AND BY COVID-19 IN BRAZIL IN 2020
Authors: dos Santos Alcione Miranda , de Souza Bruno Feres , de Carvalho Carolina Abreu , Garcia Campos Marcos Adriano , Alves de Oliveira Bruno Luciano Carneiro , Diniz Eduardo Moraes , Freitas Carvalho Branco Maria dos Remédios , de Sousa Queiroz Rejane Christine , de Carvalho Vitória Abreu , Machado Araújo Waleska Regina , da Silva e Antônio Augusto Moura
Published: August 2021

Objective

To estimate the 2020 all-cause and COVID-19 excess mortality according to sex, age, race/color, and state, and to compare mortality rates by selected causes with that of the five previous years in Brazil.

Methods

Data from the Mortality Information System were used. Expected deaths for 2020 were estimated from 2015 to 2019 data using a negative binomial log-linear model.

Results

Excess deaths in Brazil in 2020 amounted to 13.7%, and the ratio of excess deaths to COVID-19 deaths was 0.90. Reductions in deaths from cardiovascular diseases (CVD), respiratory diseases, and external causes, and an increase in ill-defined causes were all noted. Excess deaths were also found to be heterogeneous, being higher in the Northern, Center-Western, and Northeastern states. In some states, the number of COVID-19 deaths was lower than that of excess deaths, whereas the opposite occurred in others. Moreover, excess deaths were higher in men, in those aged 20 to 59, and in black, yellow, or indigenous individuals. Meanwhile, excess mortality was lower in women, individuals aged 80 years or older, and in whites. Additionally, deaths among those aged 0 to 19 were 7.2% lower than expected, with reduction in mortality from respiratory diseases and external causes. There was also a drop in mortality due to external causes in men and in those aged 20 to 39 years. Furthermore, reductions in deaths from CVD and neoplasms were noted in some states and groups.

Conclusion

There is evidence of underreporting of COVID-19 deaths and of the possible impact of restrictive measures in the reduction of deaths from external causes and respiratory diseases. The impacts of COVID-19 on mortality were heterogeneous among the states and groups, revealing that regional, demographic, socioeconomic, and racial differences expose individuals in distinct ways to the risk of death from both COVID-19 and other causes.
Estimating data-driven COVID-19 mitigation strategies for safe university reopening
Authors: Yang Qihui , Gruenbacher Don M. , Scoglio Caterina M.
Published: August 2021

After one pandemic year of remote or hybrid instructional modes, universities in the United States are now planning for an in-person fall semester in 2021. However, it is uncertain what the vaccination rate will look like after students, faculty, and staff return to campus. To help inform university-reopening policies, we collected survey data on social contact patterns and developed an agent-based model to simulate the spread of COVID-19 in university settings. In this paper, we aim to identify the immunity threshold that, if exceeded, would lead to a relatively safe on-campus experience for the university population. With relaxed non-pharmaceutical interventions, we estimated that immunity in at least 60% of the university population is needed for safe university reopening. Still, attention needs to be paid to extreme events that could lead to huge infection size spikes. At an immune level of 60%, continuing non-pharmaceutical interventions, such as wearing masks, could lead to an 89% reduction in the maximum cumulative infection, which reflects the possible non-negligible infection size from extreme events.
Treatment interruption is a risk factor for sickness presenteeism: a large-scale cross-sectional study during the COVID-19 pandemic
Authors: Okawara Makoto , Ishimaru Tomohiro , Tateishi Seiichiro , Hino Ayako , Tsuji Mayumi , Ogami Akira , Nagata Tomohisa , Matsuda Shinya , Fujino Yoshihisa ,   for the CORoNaWork project
Published: August 2021

Objectives

This study examined the relationship between interruption to routine medical care during the coronavirus disease 2019 pandemic and sickness presenteeism among workers in Japan.

Methods

A cross-sectional study using data obtained from an internet monitor questionnaire was conducted. Interruption to medical care was defined based on the response “I have not been able to go to the hospital or receive treatment as scheduled.” The fraction of sickness presenteeism days in the past 30 days was employed as the primary outcome. A fractional logit model was used for analysis to treat bounded data.

Results

Of the 27,036 participants, 17,526 (65%) were workers who did not require routine medical care, 8,451 (31%) were using medical care as scheduled, and 1,059 (4%) experienced interrupted medical care. The adjusted odds ratio (aOR) of sickness presenteeism was significantly higher among workers who experienced interrupted medical care (3.44; 95% confidence interval [CI]: 3.04–3.89) than those who did not require routine medical care. In terms of symptoms, the highest aOR was observed among workers with mental health symptoms (aOR: 5.59, 95%CI: 5.04–6.20).

Conclusions

This study suggests the importance of continuing necessary treatment during a pandemic to prevent presenteeism.
Mental State of Inpatients with COVID-19: a Computational Psychiatry Approach
Authors: Sorokin M.Yu. , Palchikova E.I. , Kibitov A.A. , Kasyanov E.D. , Khobeysh M.A. , Zubova E.Yu.
Published: August 2021

The overload of healthcare systems around the world and the danger of infection have limited the ability of researchers to obtain sufficient and reliable data on psychopathology in hospitalized patients with COVID-19. The relationship between severe SARS-CoV-2 infection and specific mental disturbances remains poorly understood.

Aim

to reveal the possibility of identifying the typology and frequency of psychiatric syndromes associated with acute COVID-19 using cluster analysis of discrete psychopathological phenomena.

Materials and methods

Descriptive data on the mental state of 55 inpatients with COVID-19 were obtained by young-career physicians with psychiatric backgrounds. Classification of observed clinical phenomena was performed with k-means cluster analysis of variables codded from the main psychopathological symptoms. Dispersion analysis with p-level 0.05 was used to reveal the cluster’s differences in demography, parameters of inflammation and respiration function collected on the basis of the original medical records.

Results

Three resulting clusters of patients were identified: persons with anxiety, disorders of fluency and tempo of thinking, mood, attention, motor-volitional sphere, reduced insight, and pessimistic plans for the future (n=11); persons without psychopathology (n=37); persons with disorientation, disorders of memory, attention, fluency, and tempo of thinking, reduced insight (n=7). The development of a certain type of impaired mental state was specifically associated with: age, lung lesions according to computed tomography, saturation, respiratory rate, C-reactive protein level, platelet count.

Conclusion

The prevalence and typology of psychiatric disorders in patients with acute COVID-19 were described using the computational psychiatry approach.