bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupotomy combined with massage for cervical spondylotic radiculopathy
Authors: Dai Wenkang , Wang Xiongwei , Xie Rui , Zhuang Minghui , Chang Xiaojuan , Jin Zhefeng , Yin He , Feng Minshan , Wei Xu , Yu Jie , Zhu Liguo
Published: August 2020

Background:

Cervical spondylotic radiculopathy (CSR) is a clinical syndrome of radial neck and shoulder pain. Both Massage and Acupotomy have been widely used in the treatment of CSR, in China and achieved satisfied efficacy. Therefore, the aim of this study is to systematically evaluate the clinical efficacy of acupotomy combined with massage in the treatment of CSR.

Methods:

The following electronic databases will be searched: PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Embase, SinoMed, Clinical Trials. gov, the China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. Two review authors independently search databases from their respective inception dates to September 2019 to identify potentially eligible studies. Cochrane Handbook 5.1 risk of bias assessment tool will be used to evaluate the methodological quality of the included studies. The Review Manager 5.3 will be used for all statistical analysis of the final included study.

Results:

The results of this systematic review and meta-analysis will provide a synthesis of existing evidences for the treatment of acupotomy combined with massage on CSR, especially in improving visual analog scale and symptom score.

Conclusion:

This study will summarize the current evidence of acupotomy combined with massage for the treatment of CSR. This study can further guide the promotion and clinical decisions.

Ethics and dissemination:

Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.

PROSPERO registration number:

CRD42020171825.
The effect of nebivolol on erectile function in the cases with coronary artery bypass surgery
Authors: Yang Yali , Yong Shanshan , Li Fuhao , Dong Liang , Chang Degui
Published: August 2020

Background:

Erectile dysfunction is a common disease. It affects the quality of life of both husband and wife and its prevalence is higher in patients with overt cardiovascular disease or cardiovascular risk factors. In recent years, multiple studies confirm that nebivolol exerts protective effects on erectile function against the disruptive effects of cardiopulmonary bypass in patients undergoing coronary artery bypass grafting, but its quality and efficacy have not been systematically evaluated. Therefore, it is necessary to carry out a systematic review and meta-analysis to fully evaluate the efficacy and safety of nebivolol on erectile function in the cases with coronary artery bypass grafting.

Methods and analysis:

Chinese and English literature of nebivolol on erectile function in the cases with coronary artery bypass surgery published before August 31, 2020 will be comprehensive searched in PubMed, Cochrane Library, EMBASE, WANFANG, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journal Database, Chinese biomedical document service system, and Clinicaltrials.gov. Only randomized controlled trials that meet the eligibility criteria will be included. Two researchers will independently complete literature screening, data extraction and assess the risk of bias, and the third investigator will handle disagreements. Our main evaluation includes 2 outcome indicators including the international index of erectile function 5 score and adverse events. RevMan 5.3 and Stata 14.0 will be used to conduct this systematic review. The preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) statement is followed in this protocol and the PRISMA statement will be followed in the completed systematic review.

Conclusion and dissemination:

The efficacy and safety of nebivolol on erectile function in the cases with coronary artery bypass grafting will be evaluated. We will publish the results of this systematic review in peer-reviewed journals to provide new evidence to clinicians.

Ethics and dissemination:

Ethical approval is not required as the review is a secondary study based on published literature. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make better clinical decisions.

Registration information:

INPLASY202060110.
Left bundle branch area pacing - restoring the natural order
Authors: Pestrea Catalin , Gherghina Alexandra , Ortan Florin , Cismaru Gabriel , Radu Rosu
Published: August 2020

Introduction:

Recent studies have shown that His-bundle pacing could be an alternative in patients requiring cardiac resynchronization therapy as it is comparable or better in terms of amelioration of ventricular activation, narrowing of the QRS complex, or clinical outcomes. However, in case of high threshold at the level of His-bundle or inability to correct conduction through a diseased His-Purkinje system other option should be searched like left bundle pacing.

Patient concerns:

A 77-year-old man presented to the Emergency Department for dizziness and dizziness and lightheadedness due to an intermittent 2:1 atrioventricular block with a QRS complex morphology of a major left branch block.

Diagnosis:

Given the documented symptomatic 2:1 AV block, according to the European Guideliness the patient was considered to have a class 1 indication of permanent double chamber cardiostimulation.

Interventions:

A lead delivery system with a C315 His catheter and a Select Secure 3830 69 cm pacing lead were placed at the His bundle area with important narrowing of the QRS complex but with an unacceptable high threshold. The delivery system was moved towards the apex 1,5 cm and the lead screwed deep into the septum until capture of the left bundle branch was achieved with complete normalization of the conduction troubles.

Outcomes:

At 3 month follow-up the patient was asymptomatic and the pacing and sensing thresholds remained at same values as during implantation: 0.75/0.4 ms and 14 mV respectively.

Conclusion:

Left bundle-pacing represents the next step of His-Purkinje system pacing to overcome all difficulties related to His-bundle pacing.
The safety and efficacy of Sclerosing foam on treating venous leg ulcers
Authors: Fan Weijing , Yang Xiao , Yang Baozhong , Fu Changgeng , Huang Renyan , Xv Feng , Liu Guobin
Published: August 2020

Background:

Venous leg ulcers (VLUs) are common throughout the world, which seriously affects the patient's work and life. Relevant researches suggested that sclerosing foam (SF) has potential benefits for VLUs. However, there is no consistent conclusion. The purpose of our study is to assess whether SF is effective and safe for VLUs.

Methods:

Relevant clinical randomized controlled trials will be obtained from a search of 8 databases (with no language restrictions) from their inception to May 2020: PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, and Chinese Biological Medicine. Data will be analyzed using RevMan 5.3 after literature screening and data extraction according to predefined inclusion and exclusion criteria. Cochrane Collaboration Risk of bias Tool will be applied in evaluating the quality of enrolled articles. The primary outcome is Closure of venous leg ulcers, ulcer healing rate, adverse events related to SF. The secondary outcomes include ulcer healing time, ulcer recurrence rate, pain. Risk ratio will be used for categorical data; mean differences will be used for measurement data. Where possible and appropriate, meta-analysis will be performed for each outcome.

Results:

To clarify whether Sclerosing foam can be safe and efficient on treating venous leg ulcers.

Conclusion:

Our review will provide useful information to judge whether Sclerosing Foam is an effective and safe intervention for patients with venous leg ulcers.
Light-emitting diode photobiomodulation therapy for non-specific low back pain in working nurses
Authors: Lin Yen-Po , Su Ying-Hao , Chin Shih-Fang , Chou Yu-Ching , Chia Wei-Tso
Published: August 2020

Background:

Low back pain (LBP) affects approximately 51% to 57% of hospital nurses and nurses’ aides in Europe. New high-risk groups include home- and long-term-care nurses and physiotherapists. A number of European countries are experiencing a shortage of healthcare workers. Light therapy has been shown to be an effective treatment for various musculoskeletal disorders, including lateral epicondylitis, temporomandibular joint pain, carpal tunnel syndrome, and delayed-onset muscle soreness. A systematic review and meta-analysis demonstrated that low-level laser therapy is an effective method for relieving non-specific chronic low back pain (NSCLBP). However, the efficacy of light-emitting diode (LED) therapy for NSCLBP is disputed. This study aims to evaluate the effect of LED therapy on NSCLBP.

Methods and analysis:

We conducted a prospective, double-blind, randomized placebo-controlled trial of 148 patients with NSCLBP. The patients were randomly assigned to 2 groups: intervention group, where patients received LED photobiomodulation therapy 3 times a week for 2 weeks, and the sham group, where patients had sham therapy 3 times a week for 2 weeks. Primary outcome measures included the visual analog scale for pain, lumbar active range of motion assessments, and chair-rising times. Secondary outcome measures included a multidimensional fatigue inventory, fear-avoidance beliefs questionnaire, and the Oswestry disability index. The outcome measures were assessed before therapy and 2weeks, 4 weeks, 8 weeks, 12 weeks, and 6 months after the first interventions were completed.

Discussion:

This study is a prospective, single-center, double-blind, randomized, controlled study. This study aims to research the efficacy of a 2-week LED program for NSCLBP working nurse. Our results will be useful for patients, working nurses, nurses’ aides, and other healthcare workers with chronic low back pain.

Trial registration number:

NCT04424823
Efficacy and safety of Shufeng Jiedu capsule for coronavirus disease 2019 (COVID-19)
Authors: Li Runmin , Li Ying , Li Bingchen , Sun Haiyang , Liu Xinyu , Ge Xin , Liu Yuanxiang , Yang Jiguo
Published: August 2020

Background:

From the end of 2019 to the present, coronavirus disease 2019 (COVID-19) has put considerable pressure on the worlds medical system and caused significant mortality and economic losses around the world. In China, the Shufeng Jiedu capsule has been widely used in the treatment of COVID-19, but there is still a lack of evidence-based medical evaluation.

Methods:

According to the retrieval strategies, randomized controlled trials (RCTs) on the Shufeng Jiedu capsule for COVID-19 were obtained from CNKI, WanFang, VIP, PubMed, Embase and Cochrane Library, regardless of publication date, or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using RevMan 5.3 and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated.

Results:

This study will evaluate the efficacy and safety of the Shufeng Jiedu capsule in the treatment of COVID-19 and provide a more reasonable choice of medication in clinical practice.

Conclusion:

Our findings will provide references for future clinical decision and guidance development.

Registration:

INPLASY registration number: INPLASY202070024.
A systematic review and meta-analysis of the efficacy and safety of western medicine routine treatment combined with Chinese herbal medicine in the treatment of COVID-19
Authors: Wang Xuemei , Xie Ping , Sun Guojuan , Deng Zhumei , Zhao Min , Bao Shuting , Zhou Yunxia
Published: August 2020

Background:

COVID-19 is a global public health emergency. At present, there is no highly effective medicine for the prevention and treatment of 2019-nCoV. Western medicine for COVID-19 is mainly based on symptomatic support therapy. Chinese herbal medicine has been used to prevent infectious diseases for thousands of years in China. Western medicine routine treatment combined with Chinese herbal medicine is an alternative clinical option but lacks evidence-based medical evidence. The systematic review protocol aims to formulate a research plan that can evaluate the efficacy and safety of western medicine routine treatment combined with Chinese herbal medicine for COVID-19.

Methods:

We will search the following eight databases: Cochrane Library, PubMed, Embase, Medline, CNKI, Wanfang, VIP, and CBM. The search time is up to the end of July 2020. Two authors will independently complete literature screening, data extraction, and risk of bias assessment. In case of disagreement, the third author will assist in the judgment. The primary outcome will be the clinical cure rate. The secondary outcome will be accounting symptoms, fever time, time of virus nucleic acid turning negative, check the condition by drawing blood, pneumonia absorption rate, patient hospitalization time, severe conversion rate and case fatality rate, adverse reactions, and adverse events. Revman 5.3 will be used for systematic reviews and meta-analysis. The report of the protocol will follow the PRISMA-P statement, and the report of the systematic review and meta-analysis will follow the PRISMA statement.

Results:

We will provide evidence-based medical evidence of the efficacy and safety of western medicine routine treatment combined with Chinese herbal medicine for COVID-19. The findings will be published in peer-reviewed journals.

Registration details:

CRD42020190106.
Efficacy and safety of Kanglaite injection for gastric cancer
Authors: Hou Daorui , Yang Liangjun , Xiong Jian , Xiong Lu
Published: August 2020

Background:

Kanglaite injection is a broad-spectrum anti-tumor drug, which is extracted from the seeds of the Chinese medicinal herb Coix lacryma-jobi, and has been widely used for the treatment of gastric cancer (GC). This study aimed to systematically investigate the efficacy and safety of Kanglaite injection for the treatment of GC.

Methods:

We will perform the comprehensive literature search in English and Chinese electronic database from its inception to June 2020. Two trained researchers will independently select the qualified studies for data extraction and assess the quality and risk of bias. Cochrane Risk of Bias tool will be used to assess the risk of bias of included studies. The outcomes included overall response rate, complete response rate, 3-year progression–free survival rate, 3-year overall survival rate, and different types of treatment-related adverse events. Funnel plot analysis and Egger test will be used to assess the publication bias. Finally, the quality of evidence will be assessed by the grading of recommendations assessment, development, and evaluate system . We will calculate the risk ratio as well as their 95% confidence intervals of these outcomes and pool the results using RevMan 5.4 software and STATA 16.0 software.

Results:

The results of our research will be published in a peer-reviewed journal.

Conclusion:

The conclusion of our systematic review will provide evidence to judge whether Kanglaite injection is an effective intervention for patient with GC.

OSF registration number:

10.17605/OSF.IO/HF679.
The efficacy and safety of Chinese herbal compound in pediatric patients with allergic rhinitis
Authors: Zhang Mengni , Fan Yihua , Tian Chunying , Xie Yue , Huang Yao , Yang Shasha , Zhang Qinxiu
Published: August 2020

Background:

We design this study to assess the efficacy and safety of Chinese herbal compound for allergic rhinitis in children.

Methods:

PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) will be searched from the establishment of each database to July 2020. Randomized controlled trials of Chinese herbal compound for the treatment of allergic rhinitis in children will be included. Two researchers will screen the literature, extract data, and assess the risk of bias independently. Statistical analysis will be performed in RevMan 5.3.

Results:

This study will summarize high quality evidence of randomized controlled trials on exploring the efficacy and safety of Chinese herbal compound for allergic rhinitis in children.

Conclusions:

The findings of study will provide scientific evidence of the efficacy and safety of Chinese herbal compound for allergic rhinitis in children for clinician and further studies.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/Q5TRZ.
Diagnosis of liver tumors by multimodal ultrasound imaging
Authors: Hu Jia , Zhou Zhi-Yu , Ran Hong-Ling , Yuan Xin-Chun , Zeng Xi , Zhang Zhe-Yuan
Published: August 2020

To investigate the diagnostic value of multimodal ultrasound imaging composed of conventional ultrasonography (US), contrast-enhanced ultrasonography (CEUS), and shear wave elastography (SWE) for liver tumors.

Between October 2017 and October 2019, US, CEUS, and SWE examinations of a total of 158 liver tumors in 136 patients at The First Affiliated Hospital of Nanchang University were performed. The histopathological or imaging diagnostic results were used as controls to evaluate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US, CEUS, SWE, and multimodal ultrasound imaging, which combines these 3 modes, in the differential diagnosis of benign and malignant liver tumors.

Among the 158 tumors, there were 64 benign tumors, including 55 cases of hepatic hemangioma, 3 cases of focal nodular hyperplasia of the liver, 4 cases of hepatic cyst, and 2 cases of focal nonuniform distribution of fat in the liver. There were 94 malignant tumors, including 32 cases of hepatocellular carcinoma, 22 cases of intrahepatic cholangiocellular carcinoma, 29 cases of metastatic liver cancer, and 11 cases of dysplastic nodules in cirrhotic liver. In the diagnosis of benign and malignant liver tumors, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 82.56%, 68.06%, 75.96%, 75.53%, and 76.56% for US; 92.39%, 86.36%, 89.87%, 90.43%, and 89.06% for CEUS; 87.14%, 76.81%, 82.91%, 82.98%, and 82.81% for SWE; and 97.85%, 95.38%, 96.83%, 96.81%, and 96.88% for multimodal ultrasound imaging, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were all significantly higher for multimodal ultrasound imaging than those values for US, CEUS, and SWE (all P < .05). The areas under the receiver operating characteristic curve for US, CEUS, SWE, and multimodal ultrasound imaging in the diagnosis of benign and malignant liver tumors were 0.760, 0.897, 0.829, and 0.968, respectively.

US, CEUS, and SWE all have diagnostic value in the diagnosis of benign and malignant liver tumors. Multimodal ultrasound imaging could significantly increase the accuracy of the diagnosis of benign and malignant liver tumors and has higher value for clinical application.
Risk factors for ulcerative colitis-associated colorectal cancer
Authors: de Campos Silva Elen Farinelli , Baima Julio Pinheiro , de Barros Jaqueline Ribeiro , Tanni Suzana Erico , Schreck Thomas , Saad-Hossne Rogerio , Sassaki Ligia Yukie
Published: August 2020

Inflammatory bowel disease is associated with an increased risk of colorectal cancer. The study aims to identify the risk factors for ulcerative colitis-colorectal cancer and to perform a survival curve analysis of the outcome.

This retrospective cohort study included 254 patients from March 2016 to October 2017. Age, age at diagnosis, follow-up time, smoking status, and family history of colorectal cancer were analyzed as risk factors for colorectal cancer.

The mean patient age was 46.6 ± 16.9 years; 5.5% of the patients were smokers and 49.6% had pancolitis. Six patients (2.36%) had colorectal cancer, which was associated with age at diagnosis (odds/hazard ratio 1.059 [95% confidence interval: 1.001–1.121]; P = .04), family history of colorectal cancer (12.992 [1.611–104.7]; P = .02), and follow-up time (0.665 [0.513–0.864]; P = .002). Active smoking was the main identified risk factor, after both logistic (8.477 [1.350–53.232]; P = .02) and Cox proportional-hazards (32.484 [2.465–428.1]; P = .008) regression analysis. The risk of colorectal cancer was 3.17% at 10 years and 4.26% at 20 years of follow-up.

Active smoking and family history were identified as risk factors for colorectal cancer. These findings should aid the early identification of patients who require vigorous surveillance, and prevent exposure to risk factors.
Clinical and radiological outcomes of hemivertebra resection for congenital scoliosis in children under age 10 years
Authors: Yang Jae Hyuk , Chang Dong-Gune , Suh Seung Woo , Kim Woon , Park Jewel
Published: August 2020

The surgical treatment of congenital scoliosis under 10 years is difficult as it involves resecting vertebrae. Moreover, patient follow-up after surgery is extremely important because the patient is a child whose growth has not been completed. However, there are very few long-term follow-up studies after surgical treatment of congenital scoliosis. Therefore, this study is designed to evaluate surgical outcomes after posterior hemivertebra resection in children under 10 years and its long-term effects.

Twenty-one patients with congenital scoliosis who were younger than 10 years at the time of the surgery and received posterior hemivertebra resection and fusion using pedicle screw fixation were included in this study.

There were significant improvements in the main curve, coronal balance, sagittal vertical axis, thoracic kyphosis, and lumbar lordosis after surgery (P < .001, .021, .047, .043, .006, respectively). Coronal balance, sagittal vertical axis, thoracic kyphosis, and lumbar lordosis remained within the normal range during the follow-up period; however, main curve deteriorated significantly (P = .005). Trunk appearance of perception scale improved significantly after surgery (P = .031) and was maintained during the follow-up period (P = .078).

In conclusion, posterior hemivertebra resection and fusion using pedicle screw fixation in patients under 10 years old with congenital scoliosis is a safe and effective procedure that can achieve rigid fixation and deformity correction. Complete resection of the hemivertebra is important for deformity correction and prevention of curve progression, and careful long-term follow-up is necessary.
Proof of critical speed of high-speed rail underlain by stratified media
Authors: Kausel Eduardo , Estaire José , Crespo-Chacón Inés
Published: August 2020

As is well known, the safe travel velocity of high-speed rail must remain below a well-defined limit commonly referred to as the
critical speed
. This upper bound depends, in turn, on the speed at which waves propagate in the ground. But as models for trains in motion have increased in complexity, over the years the concept of critical speed has grown in obscurity. It was not until late in the twentieth century that it was realized that the critical speed was somehow connected to the so-called dispersion spectrum for the complete system, but until now, the justification for its application in practice has remained empirical and lacking in rigorous mathematical explanations. This task is taken up in this article, where for the first time a most general proof is provided for the problem at hand that is applicable to any layered soil configuration when one such system is subjected to one or more loads in motion.
Knot polynomials of open and closed curves
Authors: Panagiotou Eleni , Kauffman Louis H.
Published: August 2020

In this manuscript, we introduce a method to measure entanglement of curves in 3-space that extends the notion of knot and link polynomials to open curves. We define the bracket polynomial of curves in 3-space and show that it has real coefficients and is a continuous function of the curve coordinates. This is used to define the Jones polynomial in a way that it is applicable to both open and closed curves in 3-space. For open curves, the Jones polynomial has real coefficients and it is a continuous function of the curve coordinates and as the endpoints of the curve tend to coincide, the Jones polynomial of the open curve tends to that of the resulting knot. For closed curves, it is a topological invariant, as the classical Jones polynomial. We show how these measures attain a simpler expression for polygonal curves and provide a finite form for their computation in the case of polygonal curves of 3 and 4 edges.
Lie symmetry and conservation laws for magneto-static magnetic shape memory alloys system
Authors: Haldar Krishnendu , Lagoudas Dimitris C.
Published: August 2020

Magnetic shape memory alloys (MSMAs) have drawn significant research attention as potential high actuation energy multi-functional materials. Such a dissipative material system can be considered as a solid continuum interacting with a magnetic field. A continuum-based phenomenological model provides a magneto-mechanical system of equations that simulates and predicts primary MSMA behaviours. In this work, we investigate the local symmetries of the MSMA system equations through the Lie group analysis. Symmetry breaking due to stable-unstable transition is analysed. The conservation laws are derived, and their physical meaning is scrutinized.
Whitham equations and phase shifts for the Korteweg–de Vries equation
Authors: Ablowitz Mark J. , Cole Justin T. , Rumanov Igor
Published: August 2020

The semi-classical Korteweg–de Vries equation for step-like data is considered with a small parameter in front of the highest derivative. Using perturbation analysis, Whitham theory is constructed to the higher order. This allows the order one phase and the complete leading-order solution to be obtained; the results are confirmed by extensive numerical calculations.
Crosswise tensile resistance of masonry patterns due to contact friction
Authors: Chen Shipeng , Bagi Katalin
Published: August 2020

The presented research focuses on masonry shells with dry (cohesionless) contacts. In the mechanical analysis of such structures, the material is often assumed to have zero resistance to tension. This simplification can be questioned in light of the fact that due to the frictional resistance between masonry layers compressed to each other, significant tension can be carried perpendicularly to the direction of the compression. The effect can be so considerable that the typical orange-slice cracking of masonry domes can be prevented purely by choosing a suitable brick shape and bond pattern. Based on preliminary 3DEC discrete element simulations with realistic and experimentally validated material parameters in order to understand the failure modes, the phenomenon is quantified in the present paper for the two main types of bond patterns applied in masonry shells: (i) different versions of the running bond pattern, and (ii) two versions of the herringbone pattern. The theoretically predicted failure tensile stresses are checked and validated with 3DEC discrete element simulations.
Ideonella livida sp. nov., isolated from a freshwater lake
Authors: Chen Wen-Ming , Chen Li-Chu , Sheu Der-Shyan , Tsai Jyh-Ming , Sheu Shih-Yi
Published: August 2020

A novel bacterial strain, designated TBM-1T, isolated from a freshwater lake in Taiwan, was characterized using a polyphasic taxonomic approach. Phylogenetic analyses based on 16S rRNA gene sequences and coding sequences of 92 protein clusters indicated that strain TBM-1Tformed a phylogenetic lineage in the genusIdeonella. Analysis of 16S rRNA gene sequences showed that strain TBM-1Twas most closely related toIdeonella dechloratansCCUG 30898Twith 98.4 % sequence similarity. The average nucleotide identity, average amino acid identity and digital DNA–DNA hybridization values between strain TBM-1Tand closely related strains of the genusIdeonellawere 74.4–77.5 %, 69.7–75.4 % and 19.8–21.8 %, respectively, supporting that strain TBM-1Trepresents a novel species of the genusIdeonella. Cells were Gram-stain-negative, motile by means of a single polar flagellum, rod-shaped and formed blue colonies. Optimal growth occurred at 30 °C, pH 6 and 0 % NaCl. The predominant fatty acids of strain TBM-1Twere summed feature 3 (C16 : 1 ω7cand/or C16 : 1 ω6c), C18 : 1 ω7cand C16 : 0. The polar lipid profile consisted of a mixture of phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, two uncharacterized aminophospholipids and two uncharacterized phospholipids. The main polyamine was putrescine. The major isoprenoid quinone was Q-8. The estimated genome size was 5.26 Mb, with an average G+C content of 70.0 mol%. On the basis of phenotypic and genotypic properties and phylogenetic inference, strain TBM-1Tshould be classified in a novel species of the genusIdeonella, for which the nameIdeonella lividasp. nov. is proposed. The type strain is TBM-1T(=BCRC 81199T=LMG 31339T).
Community-acquired infection caused by the uncommon hypervirulent Klebsiella pneumoniae ST66-K2 lineage
Authors: Rodrigues Carla , d’Humières Camille , Papin Grégory , Passet Virginie , Ruppé Etienne , Brisse Sylvain
Published: August 2020

Klebsiella pneumoniae

(Kp) reference strain Kp52.145 is widely used in experimental

Klebsiella

pathophysiology. Since 1935, only one other strain of the same sublineage (sequence type ST66, capsular serotype K2) was isolated (AJ210, Australia). Here, we describe a community-acquired invasive infection caused by a ST66-K2 Kp strain in France. Four hypermucoviscous Kp isolates responsible for acute otitis media, meningitis, bacteraemia and bacteriuria, respectively, were obtained from a patient with a history of chronic alcoholism and diabetes mellitus, and infected with HIV. The isolates were characterized by phenotypic and genomic methods. The four genetically identical ST66-K2 isolates presented a full antimicrobial susceptibility profile, including to ampicillin, corresponding to a single strain (SB5881), which was more closely related to AJ210 (135 SNPs) than to Kp52.145 (388 SNPs). Colibactin and yersiniabactin gene clusters were present on the integrative and conjugative element ICEKp10 in the chromosome. The two plasmids from Kp52.145 were detected in SB5881. In addition to carrying genes for virulence factors RmpA, aerobactin and salmochelin, plasmid II has acquired in SB5881, the conjugation machinery gene cluster from plasmid I. We report the first case of community-acquired infection caused by a hypervirulent ST66-K2 Kp strain in Europe. This demonstrates the long-term persistence of the high-virulence and laboratory model ST66-K2 sublineage. The combination of a conjugative apparatus and major virulence genes on a single plasmid may contribute to the co-occurrence of hypervirulence and multidrug resistance in single Kp strains.
Piloting the Clinical Value of Wearable Cardiorespiratory Monitoring for People with Cystic Fibrosis
Authors: Vandendriessche Benjamin , Van den Bergh Bertold , Storms Valerie , Chmiel James F. , Roesch Erica A.
Published: August 2020

Introduction

Cystic Fibrosis (CF) is a disease without a primary cure that requires lifelong care and is characterized by pulmonary exacerbations (PEx). Wearable devices could provide a way for long-term monitoring of disease progression and early signs of PEx to intervene as early as possible, thereby improving long-term outcomes.

Methods

In-hospital feasibility study (n = 26) to 1) assess the ability of Byteflies Sensor Dot to collect relevant cardiorespiratory data in people with CF and its compatibility with clinical workflows, 2) identify candidate digital biomarkers, and 3) collect user feedback from patients and healthcare providers.

Results

Collected sample-level biopotential, bioimpedance and actigraphy data were of high quality. Sensor Dot heart rate (HR) correlated with hospital HR, whereas respiratory rate (RR) did not. HR and RR were associated with CF severity, and HR and coughing with PEx. Willingness to use the device was very high with CF patients and study coordinators considered the device easy-to-use.

Conclusion

Determining if a wearable is fit-for-purpose is a long and multidisciplinary process that requires involvement from all stakeholders as early as possible in the development process. Our pilot identified interesting correlations between cardiorespiratory parameters as measured by the wearable, and CF severity and PEx. Together with the usability data, this will inform the next steps in the clinical development process.
Ultrasound measures of intrinsic foot muscle size and motor activation following lateral ankle sprain and chronic ankle instability. A cross-sectional study
Authors: Fraser John J. , Koldenhoven Rachel , Hertel Jay
Published: August 2020

Objectives

To assess the effects of ankle injury status on intrinsic foot muscle (IFM) size at rest and during contraction in young adults with and without a history of lateral ankle sprain (LAS) and chronic ankle instability (CAI).

Methods

Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis (AbdH), flexor digitorum brevis (FDB), quadratus plantae (QP), and flexor hallucis brevis (FHB) were assessed at rest, and during non-resisted and resisted contraction in 22 healthy (13 females, BMI: 22.5±3.2, FPI: 4.2±3.9, FMM: 2.5±1.8), 17 LAS (9 females, BMI: 24.1±3.7, FPI: 2.5±3.4, FMM: 2.7±1.7), 21 Copers (13 females, BMI: 23.7±2.9, FPI: 3.6±4.1, FMM: 1.8±1.3), and 20 CAI (15 females, BMI: 25.1±4.5, FPI: 4.4±3.6., FMM: 2.3±1.1).

Results

A multiple linear regression analysis assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (p<.001), BMI (p=.01), FPI (p=.05), and FMM*FPI interaction (p=.008) accounted for 19% of the variance (p=.002) in resting AbdH measures. Sex (p<.001) and BMI (p=.02) explained 24% of resting FDB measures (p<.001). Having a recent LAS (p=.03) and FMM (p=.02) predicted 11% of non-resisted QP contraction measures (p=.04), with sex (p<.001) explaining 13% of resting QP measures (p=.02). Both sex (p=.01) and FMM (p=.03) predicted 16% of resting FDB measures (p=.01). There were no other statistically significant findings.

Conclusions

IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. The clinical utility of these IFM ultrasonographic assessments in young adults with LAS and CAI may be limited.

Disclosures

This study was funded in part by the University of Virginia’s Curry School of Education Foundation and the Navy Medicine Professional Development Center, US Navy Bureau of Medicine and Surgery. The views expressed in this manuscript reflect the results of research conducted by the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. Lieutenant Commander John J. Fraser is a military service member and this work was prepared as part of his official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the U.S. Government.’ Title 17, USC, §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. All participants provided informed consent and this study was approved by the Institutional Review Board for Health Sciences Research at the University of Virginia in compliance with all applicable Federal regulations governing the protection of human subjects.
Clearing the fog: Is HCQ effective in reducing COVID-19 progression: A randomized controlled trial
Authors: Kamran Sultan Mehmood , Mirza Zill e Humayun , Naseem Brig Arshad , Saeed Farrukh , Azam Rizwan , Ullah Naqeeb , Ahmad Wazir , Saleem Salman
Published: August 2020

Objective

To analyze the efficacy of Hydroxychloroquine (HCQ) plus standard of care (SOC) compared with SOC alone in reducing disease progression in Mild COVID-19

Design

A single centre, open label randomized controlled trial

Place and Duration

Pulmonology department, Pak emirates Military Hospital (PEMH) from 10 April 2020 to 31 May 2020.

Methodology

Five hundred patients of both genders having age between 18-50 years who were PCR positive and had Mild COVID-19 were selected. Patients assigned to standard dose of HCQ (400mg 12 hourly day 1 then 200mg 12 hrly for next 4 days) plus SOC were 349 while 151 patients received SOC comprising of Vit C, Vit D, and Zinc only (control group). Primary outcome was progression of disease while secondary outcome was PCR negativity on day 7 and 14. The results were analyzed on SPSS version 23. P value <0.05 was considered significant.

Results

Median age of intervention group (34 ± 11.778 years) and control group (34 ± 9.813 years). Disease progressed in 16 patients, 11 (3.15%) were in intervention group as compared to 5 (3.35%) in control group, (p value = 0.865). PCR negativity in intervention and control groups were (day 7, 182 (52.1%) vs. 54 (35.7%) (p value = 0.001), (day 14, 244 (69.9%) vs. 110 (72.8%) (p value = 0.508). Consecutive PCR negativity at day 7 and 14 was observed in 240 (68.8%) in intervention group compared to 108 (71.5%) in control group. (p value = 0.231).

Conclusion

Addition of HCQ to standard of care treatment in Mild COVID-19 neither prevents disease progression nor is it significantly associated with successive PCR negativity on day 7 and 14.

Trial registration

NCT04491994

Ethical review of research project

The research project titled “Clearing the fog: Is HCQ effective in reducing COVID-19 progression” has been reviewed by ethical review committee of Pak Emirates Military Hospital (PEMH) Rawalpindi and got legal and ethical approvals prior to initiation of the research work carried out on subject. All experiments were performed in accordance with the relevant guidelines and regulation. Grant of approval is attached as separate file.
Making cotton face masks extra-protective by use of impervious cloth as the front layer to restrict flow of aerosols and droplets
Authors: Shahane-Kapse Priyanka L. , Shende M R , Kar Sumit , Deshmukh Pradeep , Bhandari Dhiraj , Narang Rahul
Published: August 2020

Introduction

One of the important measures to prevent spread of COVID-19 in community is use of face mask. Though the debate is going on regarding the airborne transmission of SARS-CoV-2 it makes reasonable point for universal use of face masks. A large variety of face masks are available in the market or people can make their own using household items. The efficacy of masks depends upon the type of cloth and number of layers of the cloth.

Material and methods

We have created an innovative mask with two layers of cotton and an impervious layer. The impervious layer made from polypropylene coated with polyurethane was applied on the outer side in the middle half of the mask in front of mouth and nose. The efficacy of this test mask was measured against N95FFR (reference standard), triple layer surgical masks and single layer cotton mask. A manikin was used wearing these masks/respirator and aerosols/droplets of diluted red coloured carbol fuchsin and fluorescent Auramine O were sprayed from distance of 1m and 2m. We also tested use of face shield. Both macroscopic and microscopic examination of the dissected masks and respirator was performed.

Results

The N95FFR was able to block the aerosols/droplets by its front layer. One triple layer surgical mask showed microscopic presence of stain in its innermost layer while the other blocked it with middle layer. The single layer cotton mask was not able to protect as we observed stain on the face itself. The test mask blocked most of the stain on impervious layer and also on the front cotton layer on lateral sides, where impervious layer was absent. When fluorescent stain was used, ultraviolet examination demonstrated that the whole area covered by test mask was clean while the other non covered area was fluorescent.

Conclusion

We believe that our innovation can be used in the community as well as in general areas of the hospital like, offices, labs, etc. and can be a better alternative to single use triple layer surgical masks. Further testing may be done by other organizations to rule out bias in our study.
False Negative Mitigation in Group Testing for COVID-19 Screening
Authors: Alizad-Rahvar A. R. , Vafadar S. , Totonchi M. , Sadeghi M.
Published: August 2020

After lifting the COVID-19 lockdown restrictions and opening businesses, screening is essential to prevent the spread of the virus. Group testing could be a promising candidate for screening to save time and resources. However, due to the high false-negative rate (FNR) of the RT-PCR diagnostic test, we should be cautious about using group testing because a group’s false-negative result identifies all the individuals in a group as uninfected. Repeating the test is the best solution to reduce the FNR, and repeats should be integrated with the group-testing method to increase the sensitivity of the test. The simplest way is to replicate the test twice for each group (the 2Rgt method). In this paper, we present a new method for group testing (the groupMix method), which integrates two repeats in the test. Then we introduce the 2-stage sequential version of both the groupMix and the 2Rgt methods. We compare these methods analytically regarding the sensitivity and the average number of tests. The tradeoff between the sensitivity and the average number of tests should be considered when choosing the best method for the screening strategy. We applied the groupMix method to screening 263 people and identified 2 infected individuals by performing 98 tests. This method achieved a 63% saving in the number of tests compared to individual testing. Our experimental results show that in COVID-19 screening, the viral load can be low, and the group size should not be more than 6; otherwise, the FNR increases significantly. A web interface of the groupMix method is publicly available for laboratories to implement this method.
A throughput serological Western blot system using whole virus lysate for the concomitant detection of antibodies against SARS-CoV-2 and human endemic Coronaviridae
Authors: Fink Simon , Ruoff Felix , Stahl Aaron , Becker Matthias , Kaiser Philipp , Traenkle Bjoern , Junker Daniel , Weise Frank , Ruetalo Natalia , Hörber Sebastian , Peter Andreas , Nelde Annika , Walz Juliane , Krause Gérard , Schenke-Layland Katja , Joos Thomas , Rothbauer Ulrich , Schneiderhan-Marra Nicole , Schindler Michael , Templin Markus F.
Published: August 2020

Background

Seroreactivity against human endemic coronaviruses has been linked to disease severity after SARS-CoV-2 infection. Assays that are capable of concomitantly detecting antibodies against endemic coronaviridae such as OC43, 229E, NL63, and SARS-CoV-2 may help to elucidate this question. We set up a platform for serum-screening and developed a bead-based Western blot system, namely DigiWest, capable of running hundreds of assays using microgram amounts of protein prepared directly from different viruses.

Methods

The parallelized and miniaturised DigiWest assay was adapted for detecting antibodies using whole protein extract prepared from isolated SARS-CoV-2 virus particles. After characterisation and optimization of the newly established test, whole virus lysates of OC43, 229E, and NL63 were integrated into the system.

Results

The DigiWest-based immunoassay system for detection of SARS-CoV-2 specific antibodies shows a sensitivity of 87.2 % and diagnostic specificity of 100 %. Concordance analysis with the SARS-CoV-2 immunoassays available by Roche, Siemens, and Euroimmun indicates a comparable assay performance (Cohen’s Kappa ranging from 0.8799-0.9429). In the multiplexed assay, antibodies against the endemic coronaviruses OC43, 229E, and NL63 were detected, displaying a high incidence of seroreactivity against these coronaviruses.

Conclusion

The DigiWest-based immunoassay, which uses authentic antigens from isolated virus particles, is capable of detecting individual serum responses against SARS-CoV-2 with high specificity and sensitivity in one multiplexed assay. It shows high concordance with other commercially available serologic assays. The DigiWest approach enables a concomitant detection of antibodies against different endemic coronaviruses and will help to elucidate the role of these possibly cross-reactive antibodies.
A longitudinal survey for genome-based identification of SARS-CoV-2 in sewage water in selected lockdown areas of Lahore city, Pakistan; a potential approach for future smart lockdown strategy
Authors: Yaqub Tahir , Nawaz Muhammad , Shabbir Muhammad Zubair , Ali Muhammad Asad , Altaf Imran , Raza Sohail , Shabbir Muhammad Abu Bakr , Ashraf Muhammad Adnan , Aziz Syed Zahid , Cheema Sohail Qadir , Shah Muhammad Bilal , Rafique Saira , Hassan Sohail , Sardar Nageen , Mehmood Adnan , Aziz Muhammad Waqar , Fazal Sehar , Khan Nadir , Khan Muhammad Tahir , Attique Muhammad Moavia , Asif Ali , Anwar Muhammad , Awan Nabeel Ahmad , Younis Muhammad Usman , Bhatti Muhammad Ajmal , Tahir Zarfishan , Mukhtar Nadia , Sarwar Huda , Rana Maaz Sohail
Published: August 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has affected more than 15 million people and, as of 22 July 2019, caused deaths of more than 0.6 million individuals globally. With the excretion of SARS-CoV-2 in the stool of symptomatic and asymptomatic COVID-19 patients, its genome detection in the sewage water can be used as a powerful epidemiological tool to predict the number of positive cases in a population. This study was conducted to detect SARS-CoV-2 genome in sewage water during the lockdown. Sewage samples, from 28 pre-selected sites, were collected on alternate days from 13-25 July, 2020 from two selected areas [Johar Town (n = 05) and Township (n = 23)], where smart lockdown were implemented by the government authorities on 9th July, 2020. Genomic RNA was extracted and the SARS-CoV-2 was detected and quantified using commercially available kit through Real-Time PCR. Out of 28, sixteen samples were positive on day one while 19, 17, 23, 17, 05 and 09 samples were positive on day 3, 5, 7, 9, 11, and 13, respectively. Results revealed a decreased positivity rate and SARS CoV-2 genome copies in sewage towards the end of lockdown however few sampling sites did not follow a clear pattern indicating the complexities in sewage water based surveillance i.e time of sampling etc. Hourly sampling from two sites for 24 hours also revealed the impact of sampling time on detection of SARS-CoV-2 genome in sewage. Results of current study insinuate a possible role of sewage-based COVID-19 surveillance in monitoring and execution of smart lockdowns.