bluuebunny/crossref_metadata_2025 huggingface dataset:
3D brain tissue physiological model with co-cultured primary neurons and glial cells in hydrogels
Authors: Raimondi Ilaria , Tunesi Marta , Forloni Gianluigi , Albani Diego , Giordano Carmen
Published: October 2020

Recently, researchers have focused on the role of gut microbiota on human health and reported the existence of a bidirectional relationship between intestinal microbiota and the brain, referred to as microbiota-gut-brain axis (MGBA). In this context, the development of an organ-on-a-chip platform recapitulating the main players of the MGBA would help in the investigations of the biochemical mechanisms involved. In this work, we focused on the development of a new, hydrogel-based, 3D brain-like tissue model to be hosted in the brain compartment of the aforementioned platform. We previously cultured primary mouse microglial cells, cortical neurons and astrocytes independently, once embedded or covered by a millimeter layer of two selected collagen-based hydrogels. We evaluated cell metabolic activity up to 21 days, cell morphology, spatial distribution and synapse formation. Then, we exploited the best performing culturing condition and developed a more complex brain-like tissue model based on the co-culture of cortical neurons and glial cells in physiological conditions. The obtained results indicate that our 3D hydrogel-based brain tissue model is suitable to recapitulate in vitro the key biochemical parameters of brain tissue.
What are we missing? Three cases of severe COVID-19 pneumonia with negative testing
Authors: Siddiqui Aisha , Singh Sukhdev , Khan Zohaib , Foster Allison , Atere Muhammed , Nfonoyim Jay M
Published: October 2020

The COVID-19 pandemic has drastically affected health care systems globally. Reverse transcriptase-polymerase chain reaction is currently the preferred method of detecting COVID-19; however, sensitivity of this test remains questionable. Incidental transmission and potential harm to infected individuals are some consequences of the failure to identify high-risk patients. We report three cases of symptomatic patients that required intensive care management with labs and imaging consistent with COVID-19 with initial false-negative reverse transcriptase-polymerase chain reaction testing. Improper sampling, viral load, and manufacturer variances of tests all contribute to reduced sensitivity. A clinical diagnosis should supplant such cases.
Examining Older Adults’ Attitudes and Perceptions of Cancer Screening and Overscreening: A Qualitative Study
Authors: Roy Siddhartha , Moss Jennifer L. , Rodriguez-Colon Sol M. , Shen Chan , Cooper Joie D. , Lennon Robert P. , Lengerich Eugene J. , Adelman Alan , Curry William , Ruffin Mack T.
Published: October 2020

Introduction/Objectives:

Screening guidelines for breast, cervical, and colorectal cancer (CRC) are less clear for older adults due to the potential harms that may result from screening. Understanding older adults’ attitudes and perceptions, especially racial/ethnic minority and underserved adults, of cancer screening can help health care providers determine how best to communicate with older adults about cancer screening and screening cessation. The objective of this study was to determine how older adults primarily from minority/underserved backgrounds perceive cancer screening and overscreening.

Methods:

Four focus groups (n = 39) were conducted with adults (>=65 years of age) in 3 community settings in south-central Pennsylvania. Two focus groups were conducted in Spanish and translated to English upon transcription. Focus group data was managed and analyzed using QSR NVivo 12. Inductive thematic analysis was used to analyze the data where themes emerged following the coding process.

Results:

The focus group participants had an average age of 74 years and were primarily female (74%) and Hispanic (69%), with 69% reporting having less than a high school degree. Four key themes were identified from the focus groups: (1) importance of tailored and targeted education/information; (2) impact of physician/patient communication; (3) impact of barriers and facilitators to screening on cancer screening cessation; and (4) awareness of importance of screening. Participants were more likely to be agreeable to screening cessation if they received specific information regarding their health status and previous medical history from their physician as to why screening should be stopped and told by their physician that the screening decision is up to them.

Conclusions:

Older adults prefer individualized information from their physician in order to justify screening cessation but are against incorporating life expectancy into the discussion. Future research should focus on developing interventions to test the effectiveness of culturally tailored screening cessation messages for older adults.
Subacute Aspergillosis “Fungal Balls” Complicating COVID-19
Authors: Patti Ravi Karan , Dalsania Nishil R. , Somal Navjot , Sinha Ankur , Mehta Sanwal , Ghitan Monica , Seneviratne Chanaka , Kupfer Yizhak
Published: October 2020

Severe acute respiratory syndrome coronavirus-2 infection (SARS-CoV-2), commonly known as COVID-19 (coronavirus disease-2019), began in the Wuhan District of Hubei Province, China. It is regarded as one of the worst pandemics, which has consumed both human lives and the world economy. COVID-19 infection mainly affects the lungs triggering severe hypoxemic respiratory failure, also providing a nidus for superimposed bacterial and fungal infections. We report the case of a 73-year-old male who presented with progressive dyspnea; diagnosed with SARS-CoV-2–related severe acute respiratory distress syndrome and complicated with lung cavitations growing Aspergillus sp. COVID-19, to our knowledge, has rarely been associated with subacute invasive pulmonary aspergillosis with aspergillomas. Subacute invasive pulmonary aspergillosis as a superimposed infection in patients with SARS-CoV-2 is a rare entity. By reporting this case, we would like to make the readers aware of this association.
Effects of Three Common Choral Configurations on Acoustic and Perceptual Measures of a Soprano Section’s Sound
Authors: Gilliam Tianna Marin
Published: October 2020

The purpose of this study was to assess the effects of three choral configurations on a soprano section’s sound. The first configuration resembled a choir section without an assigned standing position, the second configuration grouped singers by timbre, and the third used acoustic-compatibility placement. Three conductors configured a university soprano section ( N = 13) who were audio-recorded singing in each configuration and answered questions about their perceptions. Audio recordings were analyzed acoustically using long-term average spectra and perceptually through pitch analysis and listener perceptions. Results indicated that participants sang with significantly increased spectral energy in the acoustic-compatibility configuration ( p < .001), and both singer and listener participants preferred intentional standing configurations over the random standing configuration. Findings from this study suggest that choral directors can use intentional configurations in conjunction with 2 ft intersinger spacing to improve singer comfort and overall sound.
Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study
Authors: Korsten Koos , Adriaenssens Niels , Coenen Samuel , Butler Christopher , Ravanfar Behnaz , Rutter Heather , Allen Julie , Falsey Ann , Pirçon Jean-Yves , Gruselle Olivier , Pavot Vincent , Vernhes Charlotte , Balla-Jhagjhoorsingh Sunita , Öner Deniz , Ispas Gabriela , Aerssens Jeroen , Shinde Vivek , Verheij Theo , Bont Louis , Wildenbeest Joanne
Published: October 2020

Background

Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.

Methods

This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov,NCT03621930).

Results

We recruited 1040 participants (527 in season 2017–2018 and 513 in season 2018–2019) with a median age of 75 years (range 60–100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms.

Conclusion

This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
Tossing and turning: association of sleep quantity–quality with physical activity in COPD
Authors: Hirata Raquel Pastrello , Dala Pola Daniele Caroline , Schneider Lorena Paltanin , Bertoche Mariana Pereira , Furlanetto Karina Couto , Hernandes Nidia Aparecida , Mesas Arthur Eumann , Pitta Fabio
Published: October 2020

The association between characteristics of sleep and physical activity in daily life (PADL) has not yet been investigated in depth in subjects with COPD. This study evaluated whether time spent per day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population.

Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis. Subjects also underwent spirometry and 6-min walking test (6MWT).

Fifty-five subjects with moderate-to-severe COPD (28 male, 67±8 years) were studied. Subjects with total time in bed (TIB) per night ≥9 h had higher wake-after-sleep onset than TIB 7–9 h and TIB ≤7 h (195 (147–218)versus117 (75–167) and 106 (84–156) min) and more fragmented sleep than TIB ≤7 h (8.2 (6.7–14.3)versus6.3 (5.6–6.9) sleeping bouts; p<0.05 for all). Subjects with TIB ≥9 h also spent more time per day in sedentary behaviour and less time per day in PA of light and moderate-to-vigorous intensity than those with TIB 7–9 h and ≤7 h. In multiple linear regression, TIB ≥9 h was the only significant predictor of physical inactivity (β=−3.3 (−5.1, −1.6), p≤0.0001), accounting for 20% of its variation. Sleep fragmentation was frequent and more pronounced in physically inactive than active patients (7.5 (6.3–9.6)versus6.4 (5.5–7.3) sleeping bouts; p=0.027).

In summary, subjects with COPD with TIB ≥9 h·night−1have more fragmented sleep, are more sedentary and less physically active than those with <9 h·night−1, independently of the awake time. Sleep quality is frequently poor and even worse in patients classified as physically inactive.
Sarcopenia in older people with chronic airway diseases: the Rotterdam study
Authors: Benz Elizabeth , Trajanoska Katerina , Schoufour Josje D. , Lahousse Lies , de Roos Emmely W. , Terzikhan Natalie , Medina-Gomez Carolina , Verhamme Katia , Williams Ross , Stricker Bruno H. , Franco Oscar H. , Ikram M. Arfan , Rivadeneira Fernando , Brusselle Guy
Published: October 2020

Sarcopenia is a heterogeneous skeletal muscle disorder involving the loss of muscle mass and function. However, the prevalence of sarcopenia based on the most recent definition remains to be determined in older people with chronic airway diseases.

The aim was to evaluate sarcopenia prevalence and association with chronic airway diseases and its lung function in an older population, using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria.

We performed a cross-sectional analysis in 5082 participants (mean age 69.0±8.8 years, 56% females) from the Rotterdam Study. Participants with interpretable spirometry and an available assessment of sarcopenia were included. The appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS) were assessed using dual-energy X-ray absorptiometry (DXA) and a hydraulic hand dynamometer, respectively. We analysed the association between sarcopenia and chronic airway diseases by using regression models adjusted for age, sex, smoking status, total fat percentage and other relevant confounders.

Participants with chronic airway diseases had higher prevalence of probable sarcopenia (12.0%, 95% CI 10.2–13.8) and confirmed sarcopenia (3.0%, 95% CI 2.1–3.9) than without. Chronic airway diseases were associated with “probable sarcopenia” (OR 1.28, 95% CI 1.02–1.60), “confirmed sarcopenia” (OR 2.13, 95% CI 1.33–3.43), reduced HGS (β −0.51 (−0.90–−0.11)) and reduced ASMI (β −0.19 (−0.25–−0.14)). Forced expiratory volume in 1 s <80% was associated with lower HGS (β −1.03 (−1.75–−0.31)) and lower ASMI (β −0.25 (−0.36–−0.15)) than forced expiratory volume in 1 s ≥80%.

Sarcopenia was prevalent and associated with chronic airway diseases among older population. These results suggest the need for early diagnosis of sarcopenia in older people with chronic airway diseases by applying EWGSOP2 recommendations.
Molecular Dynamics Study on Tip-Based Nanomachining: A Review
Authors: Li Zihan , Yan Yongda , Wang Jiqiang , Geng Yanquan
Published: October 2020

Tip-based nanomachining (TBN) approaches has proven to be a powerful and feasible technique for fabrication of microstructures. The molecular dynamics (MD) simulation has been widely applied in TBN approach to explore the mechanism which could not be fully revealed by experiments. This paper reviews the recent scientific progress in MD simulation of TBN approach. The establishing methods of the simulation model for various materials are first presented. Then, the analysis of the machining mechanism for TBN approach is discussed, including cutting force analysis, the analysis of material removal, and the defects analysis in subsurface. Finally, current shortcomings and future prospects of the TBN method in MD simulations are given. It is hopeful that this review can provide certain reference for the follow-up research.
Hierarchical Porous MoS2/C Nanospheres Self-Assembled by Nanosheets with High Electrochemical Energy Storage Performance
Authors: Liu Hongdong , Lin Ye , Zhang Lei
Published: October 2020

To overcome the deficiency of the volume expansion of MoS2as the anode material for lithium-ion batteries (LIBs), an effective strategy was developed to design hierarchical porous MoS2/carbon nanospheres via a facile, easy-operated hydrothermal method followed by annealing. FESEM and TEM images clearly showed that nanospheres are composed of ultra-thin MoS2/C nanosheets coated with carbon layer and possess an expanded interlayer spacing of 0.98 nm. As anodes for LIBs, MoS2/carbon nanospheres deliver an initial discharge capacity of 1307.77 mAh g−1at a current density of 0.1 A g−1. Moreover, a reversible capacity of 612 mAh g−1was obtained even at 2 A g−1and a capacity retention of 439 mAh g−1after 500 cycles at 1 A g−1. The improved electrochemical performance is ascribed to the hierarchical porous structure as well as the intercalation of carbon into lattice spacing of MoS2, which offers fast channels for ion/electron transport, relieves the influence of volume change and increases electrical conductivity of electrode. Meanwhile, the expanded interlayer spacing of MoS2in MoS2/C can decrease the ion diffusion resistance and alleviate the volumetric expansion during discharge/charge cycles.
Proteomic profiling reveals differentially expressed proteins associated with amylose accumulation during rice grain filling
Authors: Zhang Hengdong , Chen Jiana , Shan Shuanglü , Cao Fangbo , Chen Guanghui , Zou Yingbin , Huang Min , Abou-Elwafa Salah F.
Published: October 2020

Background

Amylose accumulation in rice grains is controlled by genetic and environmental factors. Amylose content is a determinant factor of rice quality in terms of cooking and eating. Great variations in amylose content in indica rice cultivars have been observed. The current study was to identify differentially expressed proteins in starch and sucrose metabolism and glycolysis/gluconeogenesis pathways and their relationships to amylose synthesis using two rice cultivars possess contrasting phenotypes in grain amylose content.

Results

Synthesis and accumulation of amylose in rice grains significantly affected the variations between rice cultivars in amylose contents. The high amylose content cultivar has three down-regulated differentially expressed proteins, i.e., LOC_Os01g62420.1, LOC_Os02g36600.1, and LOC_Os08g37380.2 in the glycolysis/gluconeogenesis pathway, which limit the glycolytic process and decrease the glucose-1-phosphate consumption. In the starch and sucrose metabolic pathway, an up-regulated protein, i.e., LOC_Os06g04200.1 and two down-regulated proteins, i.e., LOC_Os05g32710.1 and LOC_Os04g43360.1 were identified (Figure 4). Glucose-1-phosphate is one of the first substrates in starch synthesis and glycolysis that are catalyzed to form adenosine diphosphate glucose (ADPG), then the ADPG is catalyzed by granule-bound starch synthase I (GBSS I) to elongate amylose.

Conclusions

The results indicate that decreasing the consumption of glucose-1-phosphate in the glycolytic process is essential for the formation of ADPG and UDPG, which are substrates for amylose synthesis. In theory, amylose content in rice can be regulated by controlling the fate of glucose-1-phosphate.
Correction to: Identification and distribution of gene clusters required for synthesis of sphingolipid metabolism inhibitors in diverse species of the filamentous fungus Fusarium
Authors: Kim Hye-Seon , Lohmar Jessica M. , Busman Mark , Brown Daren W. , Naumann Todd A. , Divon Hege H. , Lysøe Erik , Uhlig Silvio , Proctor Robert H.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Gut microbiota characteristics in mice with antibiotic-associated diarrhea
Authors: Shao Haoqing , Zhang Chenyang , Xiao Nenqun , Tan Zhoujin
Published: October 2020

Background

Antibiotic-associated diarrhea (AAD), defined as diarrhea that occurs in association with the administration of antibiotics and without another clear etiology, is one of the most common adverse drug events of antibiotics therapy. We established a diarrhea model induced by gentamycin and cefradine to investigate the microbiota characteristics in the intestinal lumen of mice with AAD and provide insights into noteworthy bacteria related to gentamicin and cefradine-associated diarrhea.

Results

The number of OTUs in the model group and the normal group was 983 and 2107, respectively, and 872 identical OTUs were shared between two groups. Species richness and species diversity of intestinal microbe were altered by antibiotics administration. PCoA showed a clear separation between AAD and health control. The dominant phyla of AAD mice were Firmicutes (52.63%) and Proteobacteria (46.37%). Among the genus with top 20 abundance, the relative abundance of 7 genera, Ruminococcus, Blautia, Enterococcus, Eubacterium, Clostridium, Coprococcus, and Aerococcus, were enriched in the model group. Based upon the LEfSe analysis, Enterococcus, Eubacterium, Ruminococcus, and Blautia were identified as potential biomarkers for AAD.

Conclusions

The bacterial diversity of the intestinal lumen was diminished after gentamicin and cefradine administration. The alterations in the abundance and composition of gut microbiota further led to the dysfunction of gut microbiota. More specifically, gentamicin and cefradine significantly increased the abundance of the opportunistic pathogens, of which Enterococcus and Clostridium were the most prominent and most worthy of attention.
Genome-wide identification and comparative analysis of diacylglycerol kinase (DGK) gene family and their expression profiling in Brassica napus under abiotic stress
Authors: Tang Fang , Xiao Zhongchun , Sun Fujun , Shen Shulin , Chen Si , Chen Rui , Zhu Meichen , Zhang Qianwei , Du Hai , Lu Kun , Li Jiana , Qu Cunmin
Published: October 2020

Background

Diacylglycerol kinases (DGKs) are signaling enzymes that play pivotal roles in response to abiotic and biotic stresses by phosphorylating diacylglycerol (DAG) to form phosphatidic acid (PA). However, no comprehensive analysis of theDGKgene family had previously been reported inB. napusand its diploid progenitors (B. rapaandB. oleracea).

Results

In present study, we identified 21, 10, and 11DGKgenes fromB. napus,B. rapa, andB. oleracea, respectively, which all contained conserved catalytic domain and were further divided into three clusters. Molecular evolutionary analysis showed that speciation and whole-genome triplication (WGT) was critical for the divergence of duplicatedDGKgenes. RNA-seq transcriptome data revealed that, with the exception ofBnaDGK4andBnaDGK6,BnaDGKgenes have divergent expression patterns in most tissues. Furthermore, someDGKgenes were upregulated or downregulated in response to hormone treatment and metal ion (arsenic and cadmium) stress. Quantitative real-time PCR analysis revealed that differentBnaDGKgenes contribute to seed oil content.

Conclusions

Together, our results indicate thatDGKgenes have diverse roles in plant growth and development, hormone response, and metal ion stress, and in determining seed oil content, and lay a foundation for further elucidating the roles ofDGKsinBrassicaspecies.
Influence of cigarette smoking on biventricular systolic function independent of respiratory function: a cross-sectional study
Authors: Watanabe Yusuke , Tajiri Kazuko , Suzuki Atsuko , Nagata Hiroyuki , Kojima Masayuki
Published: October 2020

Background

Cigarette smoking harms nearly every organ, including the heart and lungs. A comprehensive assessment of both cardiac and respiratory function is necessary for evaluating the direct effects of tobacco on the heart. However, few previous studies examining the effects of cigarette smoking on cardiac function included an assessment of lung function. This cross-sectional study investigated the influence of cigarette smoking on cardiac function, independent of respiratory function.

Methods

We retrospectively reviewed the medical records of 184 consecutive cases that underwent both spirometry and transthoracic echocardiography around the same time (within 1 month) in one hospital from April 2019 to March 2020. Participants were classified into three groups based on lifetime smoking exposure (pack-years): non-smoker (n = 49), low exposure (1–20 pack-years, n = 40), and high exposure (≥ 20 pack years, n = 95). Multiple linear regression analysis was used to assess the relationship among cigarette smoking, and cardiac and respiratory functions. The relationship between selected dependent variables and lifetime pack-years was assessed in two models with multiple linear regression analysis. Model 1 was adjusted for age and male sex; and Model 2 was adjusted for Model 1 plus forced expiratory volume percentage in 1 s and forced vital capacity percentage.

Results

Compared with the non-smokers, the participants with high smoking exposure had lower left ventricular (LV) systolic function and larger LV size. Multiple linear regression analysis revealed a negative association of cumulative lifetime pack-years with LV and right ventricular (RV) systolic functions, even after adjustment for age, sex, and spirometric parameters (forced expiratory volume percentage in 1 s and forced vital capacity percentage). Meanwhile, there was no significant association of smoking exposure with LV diastolic function (E/e′ and E/A) and RV diastolic function (e′t and e′t/a′t).

Conclusions

Cumulative smoking exposure was associated with a negative effect on biventricular systolic function in patients with relatively preserved cardiac function, independent of respiratory function.
An evaluation of DistillerSR’s machine learning-based prioritization tool for title/abstract screening – impact on reviewer-relevant outcomes
Authors: Hamel C. , Kelly S. E. , Thavorn K. , Rice D. B. , Wells G. A. , Hutton B.
Published: October 2020

Background

Systematic reviews often require substantial resources, partially due to the large number of records identified during searching. Although artificial intelligence may not be ready to fully replace human reviewers, it may accelerate and reduce the screening burden. Using DistillerSR (May 2020 release), we evaluated the performance of the prioritization simulation tool to determine the reduction in screening burden and time savings.

Methods

Using a true recall @ 95%, response sets from 10 completed systematic reviews were used to evaluate: (i) the reduction of screening burden; (ii) the accuracy of the prioritization algorithm; and (iii) the hours saved when a modified screening approach was implemented. To account for variation in the simulations, and to introduce randomness (through shuffling the references), 10 simulations were run for each review. Means, standard deviations, medians and interquartile ranges (IQR) are presented.

Results

Among the 10 systematic reviews, using true recall @ 95% there was a median reduction in screening burden of 47.1% (IQR: 37.5 to 58.0%). A median of 41.2% (IQR: 33.4 to 46.9%) of the excluded records needed to be screened to achieve true recall @ 95%. The median title/abstract screening hours saved using a modified screening approach at a true recall @ 95% was 29.8 h (IQR: 28.1 to 74.7 h). This was increased to a median of 36 h (IQR: 32.2 to 79.7 h) when considering the time saved not retrieving and screening full texts of the remaining 5% of records not yet identified as included at title/abstract. Among the 100 simulations (10 simulations per review), none of these 5% of records were a final included study in the systematic review. The reduction in screening burden to achieve true recall @ 95% compared to @ 100% resulted in a reduced screening burden median of 40.6% (IQR: 38.3 to 54.2%).

Conclusions

The prioritization tool in DistillerSR can reduce screening burden. A modified or stop screening approach once a true recall @ 95% is achieved appears to be a valid method for rapid reviews, and perhaps systematic reviews. This needs to be further evaluated in prospective reviews using the estimated recall.
Extracting medication information from unstructured public health data: a demonstration on data from population-based and tertiary-based samples
Authors: Chen Robert , Ho Joyce C. , Lin Jin-Mann S.
Published: October 2020

Background

Unstructured data from clinical epidemiological studies can be valuable and easy to obtain. However, it requires further extraction and processing for data analysis. Doing this manually is labor-intensive, slow and subject to error. In this study, we propose an automation framework for extracting and processing unstructured data.

Methods

The proposed automation framework consisted of two natural language processing (NLP) based tools for unstructured text data for medications and reasons for medication use. We first checked spelling using a spell-check program trained on publicly available knowledge sources and then applied NLP techniques. We mapped medication names into generic names using vocabulary from publicly available knowledge sources. We used WHO’s Anatomical Therapeutic Chemical (ATC) classification system to map generic medication names to medication classes. We processed the reasons for medication with the Lancaster stemmer method and then grouped and mapped to disease classes based on organ systems. Finally, we demonstrated this automation framework on two data sources for Mylagic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS): tertiary-based (n = 378) and population-based (n = 664) samples.

Results

A total of 8681 raw medication records were used for this demonstration. The 1266 distinct medication names (omitting supplements) were condensed to 89 ATC classification system categories. The 1432 distinct raw reasons for medication use were condensed to 65 categories via NLP. Compared to completion of the entire process manually, our automation process reduced the number of the terms requiring manual labor for mapping by 84.4% for medications and 59.4% for reasons for medication use. Additionally, this process improved the precision of the mapped results.

Conclusions

Our automation framework demonstrates the usefulness of NLP strategies even when there is no established mapping database. For a less established database (e.g., reasons for medication use), the method is easily modifiable as new knowledge sources for mapping are introduced. The capability to condense large features into interpretable ones will be valuable for subsequent analytical studies involving techniques such as machine learning and data mining.
Carbon tetrachloride (CCl4) accelerated development of non-alcoholic fatty liver disease (NAFLD)/steatohepatitis (NASH) in MS-NASH mice fed western diet supplemented with fructose (WDF)
Authors: Zhang Guodong , Wang Xiaoli , Chung Tzu-Yang , Ye Weiwei , Hodge Lauren , Zhang Likun , Chng Keefe , Xiao Yong-Fu , Wang Yixin Jim
Published: October 2020

Background

Multiple murine models of nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) have been established by using obesogenic diets and/or chemical induction. MS-NASH mouse (formally FATZO) is a spontaneously developed dysmetabolic strain that can progress from hepatosteatosis to moderate fibrosis when fed a western diet supplemented with 5% fructose (WDF). This study aimed to use carbon tetrachloride (CCl4) to accelerate and aggravate progression of NAFLD/NASH in MS-NASH mouse.

Methods

Male MS-NASH mice at 8 weeks of age were fed WDF for the entire study. Starting at 16 weeks of age, CCl4 was intraperitoneally administered twice weekly at a dose of 0.2 mL/kg for 3 weeks or 0.08 mL/kg for 8 weeks. Obeticholic acid (OCA, 30 mg/kg, QD) was administered in both MS-NASH and C57Bl/6 mice fed WDF and treated with CCl4 (0.08 mL/kg).

Results

WDF enhanced obesity and hepatosteatosis, as well as induced moderate fibrosis in MS-NASH mice similar to previous reports. Administration of CCl4 accelerated liver fibrosis with increased bridging and liver hydroxyproline contents, but had no significant impact on liver steatosis and lipid contents. High dose CCl4 caused high mortality and dramatic elevation of ALT and ASL, while low dose CCl4 resulted in a moderate elevation of ALT and AST with low mortality. Compared to C57BI/6 mice with WDF and CCl4 (0.08 mL/kg), MS-NASH mice had more prominent hepatosteatosis and fibrosis. OCA treatment significantly lowered liver triglycerides, steatosis and fibrosis in both MS-NASH and C57Bl/6 mice fed WDF with CCl4 treatment.

Conclusions

CCl4 reduced induction time and exacerbated liver fibrosis in MS-NASH mice on WDF, proving a superior NASH model with more prominent liver pathology, which has been used favorably in pharmaceutical industry for testing novel NASH therapeutics.
Expression and significance of Her2 and Ki-67 in gastric adenocarcinoma without distant metastasis: a cohort study
Authors: Wei Zhijian , Huang Lei , Zhang Xinyue , Xu Aman
Published: October 2020

Background

The significance of human epidermal growth factor receptor 2 (Her2) and nucleus-associated antigen Ki-67 expression remains controversial in gastric adenocarcinoma (GaC). The aim of this study was to investigate the expression and clinicopathologic and prognostic significance of Her2 and Ki-67 in resected GaC without distant metastasis.

Methods

Malignant tissues and clinicopathologic data were obtained from 195 patients with resected non-metastatic GaC. Immunohistochemistry staining was performed to examine the expression of Her2 and Ki-67; their association with clinicopathologic factors were investigated using logistic regression, and their association with survival was explored using Kaplan–Meier analysis and Cox proportional hazards regression.

Results

Her2 was majorly expressed in cell membrane and Ki-67 in cell nucleus in non-metastatic GaC. Stronger Her2 expression was significantly associated with better tumor differentiation, neurovascular invasion, less advanced pathological tumor (pT) stage, and more advanced pathological node (pN) stage; while Ki-67 expression was not significantly associated with any investigated clinicopathologic factors. Patients with both negative Her2 and negative Ki-67 expression had poorer tumor differentiation, and more advanced pT and pathological tumor-node-metastasis (pTNM) stages; the association with pT and pTNM stages were further confirmed by multivariable analyses, especially in node-negative disease. Her2 or Ki-67 alone was not significantly associated with pTNM stage. A strongly positive (+++) Her2 expression was associated with poorer survival in multivariable analysis only (P = 0.047); while Ki-67 or combined expression was not significantly associated with prognosis.

Conclusions

In non-metastatic GaC, Her2 expression and combined expression of Her2 and Ki-67 were associated with several clinicopathologic factors including tumor differentiation and stage, and only a +++ Her2 expression was associated with poorer prognosis in multivariable analysis with marginal significance in this study; while Ki-67 alone had both limited clinicopathologic and prognostic values.
Frequency, prognosis and treatment modalities of newly diagnosed small bowel cancer with liver metastases
Authors: Ye Xiaorong , Wang Lifu , Xing Yongjun , Song Chengjun
Published: October 2020

Background

Population-based analysis for the liver metastases of small bowel cancer is currently lacking. This study aimed to analyze the frequency, prognosis and treatment modalities for newly diagnosed small bowel cancer patients with liver metastases.

Methods

Patients with small bowel cancer diagnosed from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Binary logistic regression analysis was performed to determine predictors for the presence of liver metastases at diagnosis. Kaplan–Meier method and Cox regression analyses were performed for survival analyses.

Results

A total of 1461 small bowel cancer patients with liver metastases at initial diagnosis were identified, representing 16.5% of the entire set and 63.9% of the subset with metastatic disease to any distant site. Primary tumor with poorer histological type, larger tumor size, later N staging, more extrahepatic metastatic sites, and tumor on lower part of small intestine had increased propensity of developing liver metastases. The combined diagnostic model exhibited acceptable diagnostic efficiency with AUC value equal to 0.749. Patients with liver metastases had significant poorer survival (P < 0.001) than those without liver metastases. In addition, combination of surgery and chemotherapy (HR = 0.27, P < 0.001) conferred the optimal survival for patients with adenocarcinoma, while the optimal treatment options for NEC and GIST seemed to be surgery alone (HR = 0.24, P < 0.001) and chemotherapy alone (HR = 0.08, P = 0.022), respectively.

Conclusions

The combined predictor had a good ability to predict the presence of liver metastases. In addition, those patients with different histologic types should be treated with distinct therapeutic strategy for obtaining optimal survival.
Coverage of non-receipt of cash transfer (Livelihood Empowerment Against Poverty) and associated factors among older persons in the Mampong Municipality, Ghana – a quantitative analysis
Authors: Ottie-Boakye Doris
Published: October 2020

Background

Social assistance in the form of cash transfer or in-kind has been recognised as a social protection strategy in many developing countries to tackle poverty and provide protection for individuals and households. Ghana’s cash grant programme, Livelihood Empowerment Against Poverty (LEAP), was introduced in 2008 to support selected households with vulnerable persons including older people 65 years and above, and persons with disabilities. This paper examined the coverage of non-receipt of LEAP, and the associated factors among older persons (65+ years) in the Mampong Municipality, Ghana.

Methods

Data were extracted from the Ageing, Social Protection and Health Systems (ASPHS) survey carried out between September 2017 and October 2017 among older persons residing in LEAP-targeted communities. Data were analysed using descriptive and sequential logistic regression model techniques.

Results

The mean age of respondents was 77.0 years and 62.3% were females. Rural residents constituted 59.0%. About 42.0% had no formal education and only 20.5% had no form of caregiving. Non-receipt of LEAP was 82.7% among study respondents. The fully adjusted model showed that being married (AOR = 3.406, CI 1.127–10.290), residing in an urban location (AOR = 3.855, CI 1.752–8.484), having attained primary level of education (AOR = 0.246, CI 0.094–0.642), and not residing in the same household with a primary caregiver (AOR = 6.088, CI 1.814–20.428) were significantly associated with non-receipt of cash grant among older persons.

Conclusion

These results provide the first quantitative estimates of non-receipt coverage and its associated factors with the LEAP programme, which can inform the design of government policies related to cash transfers for older persons. The need for further research using different approaches to understand and explain the impact of cash grants on older persons’ well-being is crucial in strengthening old age social support care mechanisms in Ghana.
The MAKS-s study: multicomponent non-pharmacological intervention for people with severe dementia in inpatient care – study protocol of a randomised controlled trial
Authors: Diehl Kristina , Kratzer André , Graessel Elmar
Published: October 2020

Background

Nursing homes accommodate a large number of people with severe dementia. More than 80% of residents with dementia suffer from behavioural and psychological symptoms, that can have consequences on the perceived burden of the formal caregivers. Internationally, the number of studies on non-pharmacological interventions for people with severe dementia is very small. One way to reduce these symptoms is to meet the needs of people with severe dementia. The non-pharmacological group intervention MAKS-s, which we will investigate in this study, is intended to reduce the behavioural and psychological symptoms and to improve the quality of life of such people. Additionally, we will investigate the effects on the burden carried by formal caregivers.

Methods

With the present study, we will investigate the effectiveness of a multicomponent non-pharmacological intervention for people with severe dementia living in nursing homes (primary target group). A power analysis indicated that 144 dementia participants should initially be included. In addition, a secondary target group (nursing home staff) will be examined with respect to their dementia-related stress experiences. The study will be conducted as a cluster randomised controlled trail in Germany with a 6-month intervention phase. The nursing homes in the waitlist control group will provide “care as usual.” The primary endpoints of the study will be the behavioural and psychological symptoms of dementia and the quality of life of people with severe dementia. The total duration of the study will be 18 months. Data will be collected by using observer rating scales.

Discussion

The project has some outstanding quality features. The external validity is high, because it is situated in a naturalistic setting in nursing homes and is being carried out with available nursing employees. Due to this fact, a permanent implementation also seems to be possible. Since the participating nursing homes are disseminated across several German federal states and rural and urban regions, the results should be transferable to the entire population.

Trial registration

ISRCTN15722923 (Registration date: 07 August 2019).
French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long
Authors: Brouard Cécile , Pillonel Josiane , Boussac Marjorie , de Lédinghen Victor , Rachas Antoine , Silvain Christine , Lydié Nathalie , Chevaliez Stéphane , Pioche Corinne , Durand Julien , Lot Florence , Delarocque-Astagneau Elisabeth
Published: October 2020

Background

Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs).

Methods

The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System.

Results

Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7 to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016).

Conclusions

This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.
Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study
Authors: Boonpiam Rakchanok , Wanapirak Chanane , Sirichotiyakul Supatra , Sekararithi Ratanaporn , Traisrisilp Kuntharee , Tongsong Theera
Published: October 2020

Background

To identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for small-for-gestational-age (SGA) fetuses.

Methods

Women who underwent quadruple test for aneuploidy were followed-up for final outcomes. The multiples of the median (MoMs) of the four biochemical markers for the SGA group and those of normal fetuses were compared. The models for predicting SGA by the individual biomarkers and their combination were constructed using binary logistic regression analysis, and their diagnostic performances in predicting SGA were determined.

Results

Of 10,155 eligible pregnant women, 578 (5.7%) and 9577 (94.3%) had SGA and normal growth, respectively. High levels of AFP, b-hCG and IHA but low levels of uE3 significantly increased the risk of SGA. The constructed predictive equations had predictive performance for SGA, with areas under the receiver-operated characteristic curve of 0.724, 0.655, 0.597, 0.664 and 0.754 for AFP, b-hCG, uE3, IHA, and the combination, respectively.

Conclusion

The quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.
Impact of pre-existing cardiovascular disease on treatment patterns and survival outcomes in patients with lung cancer
Authors: Batra Atul , Sheka Dropen , Kong Shiying , Cheung Winson Y.
Published: October 2020

Background

Baseline cardiovascular disease (CVD) can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing CVD prior to their diagnosis of lung cancer.

Methods

We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015 in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between CVD and treatment patterns, and its impact on overall (OS) and cancer-specific survival (CSS), respectively. A competing risk multistate model was developed to determine the excess mortality risk of patients with pre-existing CVD.

Results

A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70 years. One-third had at least one CVD, with the most common being congestive heart failure in 15% of patients. Pre-existing CVD was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.48–0.58; P < .0001), radiotherapy (OR, 0.76; 95% CI, 0.7–0.82; P < .0001), and surgery (OR, 0.56; 95% CI, 0.44–0.7; P < .0001). Adjusting for measured confounders, the presence of pre-existing CVD predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1–1.2; P < .0001) and CSS (HR, 1.1; 95% CI, 1.1–1.1; P < .0001). However, in the competing risk multistate model that adjusted for baseline characteristics, prior CVD was associated with increased risk of non-cancer related death (HR, 1.48; 95% CI, 1.33–1.64; P < 0.0001) but not cancer related death (HR, 0.98; 95% CI, 0.94–1.03; P = 0.460).

Conclusions

Patients with lung cancer and pre-existing CVD are less likely to receive any modality of cancer treatment and are at a higher risk of non-cancer related deaths. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management of lung cancer.