bluuebunny/crossref_metadata_2025 huggingface dataset:
Reading by Pieces: Heliodorus, Sir Philip Sidney, and the Model of Romance
Authors: McIlwraith Fraser
Published: January 2022

In The Model of Poesy, William Scott asserts that Sir Philip Sidney ‘did imitate’ Heliodorus’s Aethiopika in ‘the general gate of conveyance’ when he wrote The Countess of Pembroke’s Arcadia. Sidney’s engagement with Heliodorus’s fourth-century prose fiction has long been recognized, especially in relation to the revised and composite versions of the Arcadia that appeared in print during the 1590s. Nevertheless, the close relationship between Heliodorus and Sidney’s text has rarely been viewed in the broader context of the Aethiopika’s sixteenth-century reception and has never been taken seriously as an instance of literary imitation. This essay returns to Renaissance debates over the propriety of prose epic to explore the background to Sidney’s Defence of Poesy and Arcadia and examines neglected sources on the Aethiopika which shed new light on how Heliodorus was reconciled with existing systems of poetics. The discussion explores how Sidney’s education in European Protestant circles taught him to think about literary imitation in ways that made him especially receptive to other sixteenth-century approaches to the Aethiopika, and proposes that he saw imitatio and mimēsis as closely connected. In addition, it considers how Scott used Heliodorus’s text as a critical tool with which to read the Arcadia, and suggests that Martin Crusius may have exerted a subtle yet significant influence on the Model. Finally, in showing how the Arcadia adapts the narrative form of Heliodorus’s text, the essay assesses the intricacy of Sidney’s imitative technique.
Comparative Effectiveness of Second Generation Long-acting Injectable Antipsychotics Based on Nationwide Database Research in Hungary: An Update
Authors: Takács Péter , Kunovszki Péter , Timtschenko Valeria , Fehér László , Balázs Tamás , Hegyi Ramóna , Czobor Pál , Bitter István
Published: January 2022

Greater 1-year and 2-year treatment continuation rates and longer median time to discontinuation for second-generation antipsychotic (SGA) long-acting injectables (LAIs) vs oral antipsychotics (OAPs) in Hungary were previously reported. This study reports an updated comparison between new LAIs vs OAPs in Hungary. De-identified claims data from Hungarian National Health Insurance Fund database of schizophrenia patients who were newly initiated on SGAs (November 01, 2016 to June 30, 2017) were retrospectively analyzed. Primary outcomes were likelihood of all-cause 1-year and 1.5-year discontinuation of newly initiated SGA and median time till discontinuation. Among 5400 patients, 3977 (73.6%) were OAP users and 1423 (26.4%) were LAI users. The 1-year continuation rate were 12.7% (risperidone)–34.1% (olanzapine) for OAPs and 26.4% (risperidone LAI)–78.6% (paliperidone 3-monthly [PP3M]) for LAIs. The 1.5-year continuation rates were 9.3%–29.5% for OAPs and 24.9%–76.4% for LAIs. Median (95% CI) time to discontinuation was 52 (33–67) days (clozapine)–152 (134–168) days (aripiprazole) for OAPs and 125 (64–196) days (risperidone LAI)–491 (250–not reached) days (aripiprazole LAI) for LAIs. All-cause discontinuation risk was significantly higher in all OAPs vs PP3M and aripiprazole LAI (P < .01) as well as in each LAI vs PP3M (P < .05). Patients switching on new LAIs from another LAI remained longer than those who switched from OAPs/no previous treatment. Results showed the advantage of LAIs over OAPs in terms of time to treatment discontinuation. Moreover, new SGA LAIs (PP3M) seem to be better than previous LAIs in terms of time to treatment discontinuation.
A sleep schedule incorporating naps benefits the transformation of hierarchical knowledge
Authors: Aghayan Golkashani Hosein , Leong Ruth L F , Ghorbani Shohreh , Ong Ju Lynn , Fernández Guillén , Chee Michael W L
Published: January 2022

Study Objectives

The learning brain establishes schemas (knowledge structures) that benefit subsequent learning. We investigated how sleep and having a schema might benefit initial learning followed by rearranged and expanded memoranda. We concurrently examined the contributions of sleep spindles and slow-wave sleep to learning outcomes.

Methods

Fifty-three adolescents were randomly assigned to an 8 h Nap schedule (6.5 h nocturnal sleep with a 90-minute daytime nap) or an 8 h No-Nap, nocturnal-only sleep schedule. The study spanned 14 nights, simulating successive school weeks. We utilized a transitive inference task involving hierarchically ordered faces. Initial learning to set up the schema was followed by rearrangement of the hierarchy (accommodation) and hierarchy expansion (assimilation). The expanded sequence was restudied. Recall of hierarchical knowledge was tested after initial learning and at multiple points for all subsequent phases. As a control, both groups underwent a No-schema condition where the hierarchy was introduced and modified without opportunity to set up a schema. Electroencephalography accompanied the multiple sleep opportunities.

Results

There were main effects of Nap schedule and Schema condition evidenced by superior recall of initial learning, reordered and expanded memoranda. Improved recall was consistently associated with higher fast spindle density but not slow-wave measures. This was true for both nocturnal sleep and daytime naps.

Conclusion

A sleep schedule incorporating regular nap opportunities compared to one that only had nocturnal sleep benefited building of robust and flexible schemas, facilitating recall of the subsequently rearranged and expanded structured knowledge. These benefits appear to be strongly associated with fast spindles.

Clinical Trial registration

NCT04044885 (https://clinicaltrials.gov/ct2/show/NCT04044885).
Remaking a “Failed” Masculinity: Working-Class Young Men, Breadwinning, and Morality in Contemporary Russia
Authors: Walker Charlie
Published: January 2022

Much of the sociological work examining the changing fortunes of working-class young men has emphasized their newly precarious position as well as the “hollowed out” nature of their class subjectivities. By contrast, and echoing work on the adaptability of hegemonic forms of masculinity, this article points to the ongoing salience of working-class masculinities, drawing on longitudinal research with young men in Russia’s Ul’yanovsk region between 2004 and 2013. It examines how young men are able to shift from a position of marginality to one of a complicit, breadwinning masculinity by bringing to bear a variety of social, cultural, bodily, and institutional resources rooted in their class, gender, and ethnic location. This journey also reflects young men’s negotiation of dialogical, moral selves, central to which is their acquired ability to reflect upon different ways of being a man by appealing to wider moral currents within Russian society.
Effects of feeding corn containing an alpha-amylase gene on the performance and digestibility of growing cattle
Authors: Glaser Marissa Ann , Montgomery Sean P , Vahl Chris I , Titgemeyer Evan C , Kubick Callie S , Glaser Grant I , Spore Tyler J , Hollenbeck William R , Wahl Ross A , Blasi Dale A
Published: January 2022

Two growth performance studies and two digestibility trials were conducted to evaluate the effects of feeding Enogen Feed Corn silage and corn grain to growing cattle. In Exp. 1, there were a total of four diets offered for ad libitum intake. The four diets consisted of two varieties of corn (Enogen Feed Corn [EFC] vs. yellow #2 corn [CON]) with two different methods of corn processing (dry-rolled [DR] vs. whole-shelled [WS]) and were formulated to provide 1.13 Mcal NEg/kg dry matter (DM); corn grain was 28.6% of diet DM. Average daily gain (ADG) and ending body weight tended to be greater for calves fed EFC than for those fed CON (P < 0.10). Gain:feed (G:F) was better for calves fed EFC (P < 0.01), improving by 5.5% over calves fed CON. In Exp. 2, a digestibility trial was conducted using seven cannulated Holstein steers fed the same diets from Exp. 1. Ruminal pH was not affected by corn variety (P > 0.82). Liquid passage rate was greater for CON-fed calves and associated with lower digestibility. Total tract DM and organic matter (OM) digestibilities were greater for EFC-fed calves (P < 0.04). In Exp. 3, there were four diets offered for ad libitum intake. Dietary factors were arranged as a 2 × 2 factorial and consisted of two hybrids of corn silage (EFC silage [EFC-S] vs. control silage [CON-S]) and two varieties of corn grain (EFC grain [EFC-G] vs. control [CON-G]; both were dry-rolled). Diets were formulated to provide 1.11 Mcal NEg/kg DM; corn grain was 38.5% of diet DM, and corn silage was 40% of diet DM. ADG was 6.0% greater (P < 0.01) and G:F was numerically (P < 0.14) 3.3% greater for calves fed EFC-S than for those fed CON-S, but substituting EFC-G for CON-G did not affect ADG or G:F. In Exp. 4, a digestibility trial was conducted using eight cannulated beef steers fed the same diets as Exp. 3. Liquid passage rate (P > 0.20), ruminal pH (P > 0.23), and ruminal total volatile fatty acid concentrations (P > 0.27) were unaffected by treatment. Total tract digestibilities of DM and OM were numerically greater by 2.5% and 2.2%, respectively, for calves fed the EFC-S compared with those fed CON-S. Feeding a corn hybrid containing alpha-amylase enzyme improved G:F of growing calves. Feeding EFC can benefit the beef industry by allowing less processing of grain without sacrificing performance.
Risk Factors for the Development of IgE-Mediated Food Allergy in Preschool Children with Asthma
Authors: Suleyman Ayse , Tamay Zeynep , Güler Nermin
Published: January 2022

Background

Food allergy is a component of the atopic march and may have effects on asthma. This study aimed to evaluate the risk factors for confirmed immunoglobulin E-mediated food allergies and their impact on the clinical picture in preschool children with asthma.

Methods

Clinical history and allergic assessment results were obtained from medical records and analyzed retrospectively. Preschool children with asthma were included in the study and the characteristics of food allergy and asthma were evaluated. The patients were grouped as those with food allergy (Group I, n = 60) and those without (Group II, n = 98).

Results

In patients with food allergy and asthma, the number of episodes requiring systemic steroids in the last year (p = 0.002), atopic dermatitis (p = 0.001), parental atopic disease (p = 0.009) and aeroallergen sensitivity rates (p < 0.001) was higher than patients without food allergies. The use of medium or high doses of inhaled steroids to achieve asthma control was more frequent in patients with food allergies (p = 0.014). Parental history of atopic disease [p = 0.007, odds ratio (OR): 3.27, 95% confidence interval (CI) 1.37–7.77)], atopic dermatitis (p = 0.017, OR: 2.80, 95% CI: 1.19–6.57), starting complementary food after 6 months (p = 0.004, OR: 3.9, 95% CI: 1.5–10.0) and having aeroallergen sensitivity (p < 0.001, OR: 6.01, 95% CI: 2.21–16.29) were identified as significant risk factors for food allergy.

Conclusion

Asthmatic preschool children with food allergies are more likely to have a parental atopic disease, atopic dermatitis, aeroallergen sensitivity and starting complementary food after 6 months. These patients experience more asthma attacks and need higher doses of steroids.
Associations between Gut Microbiota and Intestinal Inflammation, Permeability and Damage in Young Malawian Children
Authors: Kortekangas Emma , Fan Yue-Mei , Chaima David , Lehto Kirsi-Maarit , Malamba-Banda Chikondi , Matchado Andrew , Chingwanda Chilungamo , Liu Zhifei , Ashorn Ulla , Cheung Yin Bun , Dewey Kathryn G , Maleta Kenneth , Ashorn Per
Published: January 2022

Background

Environmental enteric dysfunction (EED) is common in low- and middle-income countries and associated with childhood undernutrition. The composition of gut microbiota has been implicated in the pathogenesis of EED. Our aim was to assess the associations between gut microbiota and EED biomarkers in rural Malawian children. We hypothesized that there would be an inverse association between microbiota maturity and diversity and fecal concentrations of EED biomarkers.

Methods

We used data from fecal samples collected at 6, 18 and 30 months from 611 children who were followed up during a nutrition intervention trial. The primary time point for analysis was 18 months. Microbiota data were obtained through 16S rRNA sequencing and variables included microbiota maturity and diversity, phylogenetic dissimilarity and relative abundances of individual taxa. EED biomarkers included calprotectin (marker of inflammation), alpha-1 antitrypsin (intestinal permeability) and REG1B (intestinal damage).

Results

There was an inverse association between microbiota maturity and diversity and fecal concentrations of all 3 EED biomarkers at 18 months (p≤0.001). The results were similar at 30 months, while at 6 months inverse associations were found only with calprotectin and alpha-1 antitrypsin concentrations. At 18 months, EED biomarkers were not associated with phylogenetic dissimilarity, but at 6 and 30 months several associations were observed. Individual taxa predicting EED biomarker concentrations at 18 months included several Bifidobacterium and Enterobacteriaceae taxa as well as potentially displaced oral taxa.

Conclusions

Our findings support the hypothesis of an inverse association between microbiota maturity and diversity and EED in rural Malawian children.
Non-invasive tests of non-alcoholic fatty liver disease
Authors: Li Guanlin , Zhang Xinrong , Lin Huapeng , Liang Lilian Yan , Wong Grace Lai-Hung , Wong Vincent Wai-Sun
Published: January 2022

For the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.
A Qualitative Study Focused on Maternity Care Professionals' Perspectives on the Challenges of Providing Care During the COVID-19 Pandemic
Authors: Brown Jill , Moore Kathryn , Keer Emma , Kane Low Lisa
Published: January 2022

Maternity care services were significantly altered with the start of the global pandemic in 2020, challenging the ways care was provided for families during childbirth. This qualitative analysis focuses on maternity care professionals' perceptions of the impact of COVID-19 on maternity care in Michigan early in the pandemic. The question “How has COVID-19 impacted your work?” was embedded into a survey focused on maternity unit culture in process across Michigan. Directed content analysis was applied to the open text responses to identify themes. From April-June 2020, 1071 surveys were completed by nurses, physicians, and midwives; 647 (60%) included responses to the COVID-19 question. Five themes emerged: (1) provider health; (2) patient care impact; (3) burdens of personal protective equipment; (4) decreased support during labor due to visitor restrictions; and (5) ethical challenges and moral distress between concerns for self and carrying out professional roles. Maternity care providers in Michigan experienced a range of complex challenges due to the pandemic, with many experiencing conflicts and questioning their role as a provider amid concerns of the effects of COVID-19 on themselves and their families. Resources are necessary to support providers who experience distress to promote well-being and retention of this essential workforce.
ELSO Guidelines for Adult and Pediatric Extracorporeal Membrane Oxygenation Circuits
Authors: Gajkowski Evan F. , Herrera Guillermo , Hatton Laura , Velia Antonini Marta , Vercaemst Leen , Cooley Elaine
Published: January 2022

Disclaimer:

This guideline describes the ECMO circuit for all patient populations. These guidelines describe safe practice based on extensive experience and are considered consensus guidelines. These guidelines are not intended to define standard of care and are revised at regular intervals as new information, devices, medications, and techniques become available.
Prevalence of Gastrointestinal Symptoms and Irritable Bowel Syndrome Among Individuals With Symptomatic Posttraumatic Stress Disorder
Authors: Kearney David J. , Kamp Kendra J. , Storms Meghan , Simpson Tracy L.
Published: January 2022

Goals:

Our aim was to describe the prevalence of irritable bowel syndrome (IBS) and other gastrointestinal symptoms in a sample of veterans with posttraumatic stress disorder (PTSD) and to examine the relationship between gastrointestinal symptoms, PTSD severity, depression severity, and number of prior traumatic events reported.

Background:

IBS and PTSD can co-occur; yet, little research has focused on describing the gastrointestinal symptoms and prevalence of IBS among veterans with PTSD.

Materials and Methods:

We examined baseline data from a randomized clinical trial of behavioral interventions for veterans with PTSD. Veterans completed questionnaires assessing gastrointestinal symptoms (Gastrointestinal Patient-Reported Outcome Measures Information Systems; PROMIS) and lifetime traumatic events. Multivariable regression analyses were performed to examine associations between gastrointestinal symptoms and the number of prior traumas reported PTSD severity, and depression symptom severity.

Results:

One hundred eighty-four veterans with a diagnosis of PTSD were included. Twenty-five percent met the Rome III criteria for IBS. Veterans reported gastrointestinal symptoms including abdominal/belly pain (36%), diarrhea (21%), constipation (18%), and bloating/gas (17%). In multivariable analyses, greater PTSD severity was associated with worse constipation (P=0.008), diarrhea (P=0.005), and gas/bloating (P=0.001) when controlling for age and sex. Higher levels of depressive symptoms severity were associated with greater abdominal/belly pain (P=0.04).

Conclusions:

Among a sample of veterans with PTSD, rates of IBS and abdominal/belly pain are greater than general US population reference values. Although levels of constipation and bloating/gas are lower than general US population reference values, increased severity of PTSD was associated with increased gastrointestinal symptoms.
Bacteremia caused by accidental injection of Bacillus licheniformis microbiota modulator through the central venous catheter
Authors: Zhong Chuan , Wang Fen , Zhou Haining , Liu Jiarui , Hu Jiewei , Chen Yongjun
Published: January 2022

Rationale:

Bacillus licheniformis (B licheniformis) is a commonly used microbiota modulator. However, infections are rarely observed in immunocompetent hosts.

Patient concerns:

A 67-year-old woman who underwent esophagectomy experienced accidental injection of B licheniformis and presented with chills followed by hyperpyrexia.

Diagnosis:

The initial diagnosis was B licheniformis bacteremia.

Intervention:

Based on our experience, the patient first received levofloxacin and ornidazole. The application of levofloxacin was retained based on the antibiogram results. After discharge, the antibiotics were changed to vancomycin and levofloxacin, based on sensitivity tests, until two consecutive blood cultures were negative.

Outcomes:

The patient recovered without any severe complications.

Lessons:

This is a rare report of the successful treatment of B licheniformis bacteremia caused by improper drug administration, which will provide a reference for the treatment of B licheniformis bacteremia.
Effect of pursed-lip breathing and forward trunk lean positions on regional chest wall volume and ventilatory pattern in older adults
Authors: Ubolnuar Nutsupa , Tantisuwat Anong , Mathiyakom Witaya , Thaveeratitham Premtip , Kruapanich Chathipat
Published: January 2022

Pursed-lip breathing (PLB) and forward trunk lean posture (FTLP) are commonly used to relieve dyspnea and improve ventilation in a rehabilitation program. However, their effect on chest wall volumes and movements in older adults without chronic obstructive pulmonary disease has never been investigated. This observational study aimed to identify the effect of combined PLB and FTLP on total and regional chest wall volumes, ventilatory pattern, and thoracoabdominal movement using in older adults. It was hypothesized that the combined PLB with FTLP would result in the highest chest wall volumes among the experimental tasks. Twenty older adults performed 2 breathing patterns of quiet breathing (QB) and PLB during a seated upright (UP) position and FTLP. An optoelectronic plethysmography system was used to capture the chest wall movements during the 4 experimental tasks. Tidal volume (VT) was separated into pulmonary ribcage, abdominal ribcage, and abdomen volume. The changes in anterior–posterior (AP) and medial–lateral (ML) chest wall diameters at 3 levels were measured and used to identify chest wall mechanics to improve chest wall volumes. The PLB significantly improved ventilation and chest wall volumes than the QB (P < .05). VT of pulmonary ribcage, VT of abdominal ribcage, and VT were significantly higher during the PLB + UP (P < .05) and during the PLB + FTLP (P < .01) as compared to those of QB performed in similar body positions. However, there was no significant in total and regional lung volumes between the PLB + UP and the PLB + FTLP. The AP diameter changes at the angle of Louis and xiphoid levels were greater during the PLB + UP than the QB + UP and the QB + FTLP (P < .01). The AP diameter changes at the umbilical level and the ML diameter changes at the xiphoid level were significantly larger during the PLB + FTLP than the QB + FTLP and the QB + UP (P < .05). The ML diameter changes at the umbilical level were significantly greater during the PLB + FTLP than the QB + UP (P < .05). However, no significant difference in the relative regional chest wall volumes and phase angle among the experimental tasks (P > .05). In conclusion, a combined PLB performed in an FTLP or UP sitting could be used as a strategy to improve chest wall volumes and ventilation in older adults.
Impact of COVID-19 on Oncology Healthcare Providers
Authors: Marshall Victoria K. , Mason Tina M. , Chavez Melody , Martinez-Tyson Dinorah , Bugajski Andrew
Published: January 2022

Background

The novel coronavirus (COVID-19) has plagued countries worldwide. This pandemic has greatly affected healthcare delivery and those providing care to vulnerable, immunocompromised patients undergoing cancer treatment, who are at a higher risk for poorer outcomes related to COVID-19.

Objective

The aim of this study was to explore the impact of COVID-19 on oncology healthcare professionals (OHCPs).

Methods

An exploratory study design was employed using semistructured interviews. A thematic analysis was completed using Atlas.ti software.

Results

Of 30 OHCP participants, most were female (90%), registered nurses (70%), and bachelor's prepared (66%). The following themes emerged: (1) pandemic-related restrictions and stress on personal lives impacted the ability of OHCPs to rejuvenate and reenergize for work; (2) fear of exposure and transmission and concern for high-risk status for contracting COVID-19; (3) limited resources and inconsistent communication about organizational policies caused additional stress, affecting OHCP trust and confidence in the system; (4) concern for the mental health of fellow OCHPs; (5) adaptation and resilience were required amidst shifting workloads, workflow, and new restrictions; and (6) importance of self-care to reduce personal/professional stressors.

Conclusions

Oncology healthcare professionals continue to face challenges of COVID-19 on their personal and professional lives yet have shown resilience during these unprecedented times.

Implications for Practice

Oncology healthcare professionals need to advocate for appropriate personal protective equipment and reliable mental health support services through employers. They should be engaged in COVID-19 task forces to ensure their challenges are heard and needs are addressed to provide quality oncology care.
Trans-Oral Robotic Surgery: 14 Cases of Pleomorphic Adenoma of the Parapharyngeal Space
Authors: Salzano Giovanni , Togo Giulia , Maglitto Fabio , Borriello Gerardo , Perri Francesco , Audino Giovanni , Vaira Luigi Angelo , Maglione Maria Grazia , Petrocelli Marzia , Califano Luigi , Ionna Franco
Published: January 2022

Purpose:

The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated with trans-oral robotic surgery (TORS). Tumors arising from the PPS comprise less than 0.5% of all head and neck tumors. Salivary gland tumors account for 40% to 50% of PPS lesions with pleomorphic adenomas representing the most common salivary tumors (80%–90%). Parapharyngeal space tumors cause nonspecific symptoms and may be difficult to diagnose.

Methods:

In our study a preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging and the results were used to plan the correct surgical approach.

Results:

In all cases we were able to employ TORS, a minimally invasive procedure that allows us to operate in narrow and anatomically complex spaces that we can only reach thanks to the use of well-articulated hand pieces.

Conclusions:

This report indicates that TORS is a safe surgical procedure for the excision of benign tumors of the PPS in selected cases.
Differentiation of Critical Illness Myopathy and Critical Illness Neuropathy Using Nerve Ultrasonography
Authors: Gruber Leonhard , Loizides Alexander , Gruber Hannes , Skalla Elisabeth , Haushammer Silke , Horlings Corinne , Beer Ronny , Helbok Raimund , Löscher Wolfgang N.
Published: January 2022

Purpose:

Intensive care unit–acquired weakness occurs frequently in intensive care unit patients, including critical illness myopathy (CIM) and critical illness polyneuropathy (CIPN). The authors present a prospective study to assess the ultrasound pattern sum score to differentiate between confirmed CIM, sensory neuropathy, and CIPN cases.

Methods:

Cross-sectional areas of 12 predefined nerve segments in 16 patients were sonographically examined. Single-nerve cross-sectional areas and ultrasound pattern sum score values were compared; results are given as P-values and receiver operating characteristic area under the curve (AUC).

Results:

In neuropathy, significant single-nerve cross-sectional area enlargement was observed in the median (P = 0.04), ulnar (P = 0.04), and fibular nerves (P = 0.0003). The ultrasound pattern sum score could reliably differentiate between pure CIM and neuropathy (P = 0.0002, AUC 0.92), CIM and sensory neuropathy (P = 0.001, AUC 0.88), and CIM and CIPN (P = 0.007, AUC 0.92), but not between sensory neuropathy and CIPN (P = 0.599, AUC 0.48).

Conclusions:

Nerve ultrasonography reliably identifies neuropathy in intensive care unit–acquired weakness, yet cannot differentiate between sensory neuropathy and CIPN. A standardized ultrasound algorithm can serve as a fast bedside test for the presence of neuropathy in intensive care unit–acquired weakness.
“It affects every aspect of your life”: A qualitative study of the impact of delaying surgery during COVID-19
Authors: Sauro KM , Smith C , Kersen J , Schalm E , Jaworska N , Roach P , Beesoon S , Brindle ME
Published: January 2022

Background

The COVID-19 pandemic has overwhelmed healthcare systems, leading many jurisdictions to reduce surgical services to create capacity (beds and staff) to care for the surge of patients with COVID-19. These decisions were made in haste, and little is known about the impact on patients whose surgery was delayed. This study explores the impact of delaying non-urgent surgeries on patients, from their perspective.

Methods

Using an interpretative description approach, we conducted interviews with adult patients and their caregivers who had their surgery delayed or cancelled during the COVID-19 pandemic in Alberta, Canada. Trained interviewers conducted semi-structured interviews. Interviews were iteratively analyzed by two independent reviewers using an inductive approach to thematic content analysis to understand key elements of the patient experience.

Results

We conducted 16 interviews with participants ranging from 27 to 75 years of age with a variety of surgical procedures delayed. We identified four interconnected themes: individual-level impacts (physical health, mental health, family and friends, work, quality of life), system-level factors (healthcare resources, communication, perceived accountability/responsibility), unique issues related to COVID-19, and uncertainty.

Interpretation

The patient-reported impact of having a surgery delayed during the COVID-19 pandemic was diffuse and consequential. While the decision to delay non-urgent surgeries was made to manage the strain on healthcare systems, our study illustrates the consequences of these decisions. We advocate for the development and adoption of strategies to mitigate the burden of distress that waiting for surgery during and after COVID-19 has on patients and their family/caregivers.
Humoral immune response of patients infected by earlier lineages of SARS-CoV-2 neutralizes wild types of the most prevalent variants in Brazil
Authors: Pauvolid-Corrêa Alex , Caetano Braulia Costa , Machado Ana Beatriz , Araújo Ferreira Mia , Valente Natalia , Neves Thayssa Keren , Geraldo Kim , Motta Fernando , Gonçalves Veloso dos Santos Valdiléa , Grinsztejn Beatriz , Mendonça Siqueira Marilda , Resende Paola Cristina
Published: January 2022

In the present study, serum samples of 20 hospitalized COVID-19 patients from Brazil who were infected by the earlier SARS-CoV-2 lineages B.1.1.28 and B.1.1.33, and by the variant of concern (VOC) Gamma (P.1) were tested by plaque reduction neutralization test (PRNT90) with wild isolates of a panel of SARS-CoV-2 lineages, including B.1, Zeta, N.10, and the VOCs Gamma, Alpha, and Delta that emerged in different timeframes of the pandemic. The main objectives of the present study were to evaluate if serum of COVID-19 patients infected by earlier lineages of SARS-CoV-2 were capable to neutralize recently emerged VOCs, and if PRNT90 is a reliable serologic method to distinguish infections caused by different SARS-CoV-2 lineages. Overall, sera collected from the day of admittance to the hospital to 21 days after diagnostic of patients infected by the two earlier lineages B.1.1.28 and B.1.1.33 presented neutralizing capacity for all challenged VOCs, including Gamma and Delta, that were the most prevalent VOCs in Brazil. Among all variants tested, Delta and N.10 presented the lowest mean of neutralizing antibody titers, and B.1.1.7, presented the highest titers. Four patients infected with Gamma, that emerged in December 2020, presented neutralizing antibodies for B.1, B.1.1.33 and B.1.1.28, its ancestor lineage. All of them had neutralizing antibodies under the level of detection for the VOC Delta. Interestingly, patients infected by B.1.1.28 presented very similar mean of neutralizing antibody titers for both B.1.1.33 and B.1.1.28. Findings presented here indicate that most patients infected in early stages of COVID-19 pandemic presented neutralizing antibodies up to 21 days after diagnostic capable to neutralize wild types of all recently emerged VOCs in Brazil, and that the PRNT90 it is not a reliable serologic method to distinguish natural infections caused by different SARS-CoV-2 lineages.
Cardiovascular, respiratory and functional effects of tele-supervised home-based exercise training in individuals recovering from COVID-19 hospitalization: A randomized clinical trial
Authors: do Amaral Vanessa Teixeira , Viana Ariane Aparecida , Heubel Alessandro Domingues , Linares Stephanie Nogueira , Martinelli Bruno , Camprigher Witzler Pedro Henrique , Orikassa de Oliveira Gustavo Yudi , de Souza Zanini Gabriel , Silva Audrey Borghi , Mendes Renata Gonçalves , Ciolac Emmanuel Gomes
Published: January 2022

Our aim was to test the hypothesis that tele-supervised home-based exercise training (exercise) is an effective strategy for improving cardiovascular, respiratory, and functional capacity parameters in individuals that were hospitalized due to coronavirus disease 2019 (COVID-19). Thirty-two individuals (52 ± 10 years; 17F) randomly assigned to exercise (N = 12) and control groups (N = 20), had their anthropometric (weight, body mass index), hemodynamic (brachial and central blood pressure), vascular (arterial stiffness), ventilatory (pulmonary function and respiratory muscle strength), and functional parameters (handgrip strength, five-time sit to stand [FTSTS], timed up and go test [TUG] and six-minute walking test [6MWT]) assessed at baseline (30 to 45 days of hospital discharged) and after 12 weeks of follow-up. Both groups similarly increased (P < 0.001) forced vital capacity (absolute and % of predicted), forced expiratory volume in the first second (absolute and % of predicted), and handgrip strength during follow-up. However, only exercise group reduced carotid-femoral pulse wave velocity (−2.0 ± 0.6 m/s, P = 0.048), and increased (P < 0.05) resting oxygen saturation (1.9 ± 0.6 %), mean inspiratory pressure (24.7 ± 7.1 cmH2O), mean expiratory pressure (20.3 ± 5.8 cmH2O) and % of predicted mean expiratory pressure (14 ± 22 %) during follow-up. No significant changes were found in any other variable during follow-up. Present findings suggest that tele-supervised home-based exercise training can a potential adjunct therapeutic to rehabilitate individuals that were hospitalized due to COVID-19.
The inactivated NDV-HXP-S COVID-19 vaccine induces a significantly higher ratio of neutralizing to non-neutralizing antibodies in humans as compared to mRNA vaccines
Authors: Carreño Juan Manuel , Raskin Ariel , Singh Gagandeep , Tcheou Johnstone , Kawabata Hisaaki , Gleason Charles , Srivastava Komal , Vigdorovich Vladimir , Dambrauskas Nicholas , Gupta Sneh Lata , Gonzalez Irene , Martinez Jose Luis , Slamanig Stefan , Sather D. Noah , Raghunandan Rama , Wirachwong Ponthip , Muangnoicharoen Sant , Pitisuttithum Punnee , Wrammert Jens , Suthar Mehul S. , Sun Weina , Palese Peter , García-Sastre Adolfo , Simon Viviana , Krammer Florian
Published: January 2022

NDV-HXP-S is a recombinant Newcastle disease virus based-vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which expresses an optimized (HexaPro) spike protein on its surface. The vaccine can be produced in embryonated chicken eggs using the same process as that employed for the production of influenza virus vaccines. Here we performed a secondary analysis of the antibody responses after vaccination with inactivated NDV-HXP-S in a Phase I clinical study in Thailand.

The SARS-CoV-2 neutralizing and spike binding activity of NDV-HXP-S post-vaccination serum samples was compared to that of matched samples from mRNA BNT162b2 (Pfizer) vaccinees. Neutralizing activity of sera from NDV-HXP-S vaccinees was comparable to that of individuals vaccinated with BNT162b2. Interstingly, the spike binding activity of the NDV-HXP-S vaccinee samples was lower than that of sera obtained from individuals vaccinated with the mRNA vaccine. This let us to calculate ratios between binding and neutralizing antibody titers. Samples from NDV-HXP-S vaccinees had binding to neutralizing activity ratios similar to those of convalescent sera suggesting a very high proportion of neutralizing antibodies and low non-neutralizing antibody titers. Further analysis showed that, in contrast to mRNA vaccination, which induces strong antibody titers to the receptor binding domain (RBD), the N-terminal domain, and the S2 domain, NDV-HXP-S vaccination induces a very RBD focused response with little reactivity to S2. This explains the high proportion of neutralizing antibodies since most neutralizing epitopes are located in the RBD. In conclusion, vaccination with inactivated NDV-HXP-S induces a high proportion of neutralizing antibodies and absolute neutralizing antibody titers comparable to those after mRNA vaccination.
Genetic risk factors have a substantial impact on healthy life years
Authors: Jukarainen Sakari , Kiiskinen Tuomo , Havulinna Aki S. , Karjalainen Juha , Cordioli Mattia , Rämö Joel T. , Mars Nina ,   FinnGen, Samocha Kaitlin E. , Ollila Hanna M. , Pirinen Matti , Ganna Andrea
Published: January 2022

The impact of genetic variation on overall disease burden has not been comprehensively evaluated. Here we introduce an approach to estimate the effect of different types of genetic risk factors on disease burden quantified through disability-adjusted life years (DALYs, “lost healthy life years”). We use genetic information from 735,748 individuals with registry-based follow-up of up to 48 years. At the individual level, rare variants had higher effects on DALYs than common variants, while common variants were more relevant for population-level disease burden. Among common variants, rs3798220 (LPA) had the strongest effect, with 1.18 DALYs attributable to carrying 1 vs 0 copies of the minor allele. Belonging to top 10% vs bottom 90% of a polygenic score for multisite chronic pain had an effect of 3.63 DALYs. Carrying a deleterious rare variant in LDLR, MYBPC3, or BRCA1/2 had an effect of around 4.1-13.1 DALYs. The population-level disease burden attributable to some common variants is comparable to the burden from modifiable risk factors such as high sodium intake and low physical activity. Genetic risk factors can explain a sizeable number of healthy life years lost both at the individual and population level, highlighting the importance of incorporating genetic information into public health efforts.

Results of the study can be explored at: https://dsge-lab.shinyapps.io/daly_genetics/
Is mandatory vaccination in population over 60 adequate to control the COVID-19 pandemic in E.U.?
Authors: Rachaniotis N.P. , Dasaklis T.K. , Fotopoulos F. , Chouzouris M. , Sypsa V. , Lyberaki A. , Tinios P.
Published: January 2022

Vaccine hesitancy, which potentially leads to refusal or delayed acceptance of COVID-19 vaccines, is considered a key driver for the increasing death toll from the pandemic in the E.U.. European Commission and several member states’ governments are either planning or have already directly or indirectly announced mandatory vaccination for individuals aged over 60, the group repeatedly proved to be the most vulnerable. In this paper, an assessment of this strategy benefits is attempted. This is done by examining the reduction of Standard Expected Years of Life Lost (SEYLL) per person of the EU population over 60 as a function of their vaccination percentage. Publicly available data and some first results of the second iteration of the SHARE COVID-19 survey conducted during the summer of 2021 on acceptance of COVID-19 vaccines are used as input.
PD-L1 blockade restores CAR T cell activity through IFNγ-regulation of CD163+ macrophages
Authors: Yamaguchi Yukiko , Gibson Jackson , Ou Kevin , Ng Rachel H. , Leggett Neena , Jonsson Vanessa D. , Zarif Jelani C. , Lee Peter P. , Wang Xiuli , Martinez Catalina , Dorff Tanya B. , Forman Stephen J. , Priceman Saul J.
Published: January 2022

Background

The immune suppressive tumor microenvironment (TME) that inhibits T cell infiltration, survival, and anti-tumor activity has posed a major challenge for developing effective immunotherapies for solid tumors. Chimeric antigen receptor (CAR)-engineered T cell therapy has shown unprecedented clinical response in treating patients with hematological malignancies, and intense investigation is underway to achieve similar responses with solid tumors. Immunologically cold tumors, including prostate cancers, are often infiltrated with abundant tumor-associated macrophages (TAMs), and infiltration of CD163+ M2 macrophages correlates with tumor progression and poor responses to immunotherapy. However, the impact of TAMs on CAR T cell activity alone and in combination with TME immunomodulators is unclear.

Methods

To model this in vitro, we utilized a novel co-culture system with tumor cells, CAR T cells, and polarized M1 or M2 macrophages from CD14+ PBMCs collected from healthy human donors. Tumor cell killing, T cell activation and proliferation, and macrophage phenotypes were evaluated by flow cytometry, cytokine production, RNA sequencing, and functional blockade of signaling pathways using antibodies and small molecule inhibitors. We also evaluated the TME in humanized mice following CAR T cell therapy for validation of our in vitro findings.

Results

We observed inhibition of CAR T cell activity with the presence of M2 macrophages, but not M1 macrophages, coinciding with a robust induction of PD-L1 in M2 macrophages. We observed similar PD-L1 expression in TAMs following CAR T cell therapy in the TME of humanized mice. PD-L1, but not PD-1, blockade in combination with CAR T cell therapy altered phenotypes to more M1-like subsets and led to loss of CD163+ M2 macrophages via IFNγ signaling, resulting in improved anti-tumor activity of CAR T cells.

Conclusion

This study reveals an alternative mechanism by which the combination of CAR T cells and immune checkpoint blockade modulates the immune landscape of solid tumors to enhance therapeutic efficacy of CAR T cells.
Automated Human Habenula Segmentation from T1-weighted Magnetic Resonance Images using V-Net
Authors: Kim Joo-won , Xu Junqian
Published: January 2022

The Habenula (Hb), a small bilateral midbrain structure, plays an important role in aversion and reward processing. Despite increasing interest in imaging human Hb structure and function, it is challenging to define the Hb in magnetic resonance imaging (MRI) due to its small size and low anatomical contrast to the surrounding thalamus. In this study, we developed a deep learning-based human Hb segmentation model. This model was trained and tested using about a thousand subjects’ 3T T1-weighted images with Hb labels from our previous myelin content-based Hb segmentation. The predicted Hb segmentation showed high similarity and small surface distance to the label; the average (across test subjects) dice similarity coefficient, mean distance, and Hausdorff distance were 0.79, 0.22 mm, and 1.63 mm, respectively. We also demonstrated out-of-sample robustness using other 7T and 3T MRI datasets. The proposed Hb segmentation method is automated, objective, fast, robust, and reliable, relieving the requirement of T2-weighted images in the established myelin content-based Hb segmentation to suite a broader range of MRI studies.
A high-throughput approach to identify reproductive toxicants among environmental chemicals using an in vivo evaluation of gametogenesis in budding yeast Saccharomyces cerevisiae
Authors: Kumar Ravinder , Oke Ashwini , Rockmill Beth , de Cruz Matthew , Verduzco Rafael , Madeira Xavier W. , Abrahamsson Dimitri P. , Robinson Joshua F. , Allard Patrick , Woodruff Tracey J. , Fung Jennifer C.
Published: January 2022

Background

Environmental chemical exposures are likely making important contributions to current levels of infertility and its increasing incidence. Yet the US produces high volumes of industrial chemicals for which there is limited data on their potential human reproduction toxicity. Current assays typically used in policy and regulatory settings involve costly and timeconsuming whole-animal rodent tests which limit the rapidity with which one can assess the thousands of chemicals yet to be tested.

Objective

Our aim was to develop a fast and reliable strategy to evaluate a large number of chemicals for reproductive toxicity by developing a high-throughput toxicity assessment using the yeast S. cerevisiae.

Methods

Yeast are chronically exposed to each environmental chemical at two doses, 30 μM and 100 μM, in a 96-well plate-based format throughout gametogenesis. Non-gametes are removed and chemicals are washed away before gamete viability is measured using absorbance at 600 nm to produce growth curves. The difference in time at half-maximal saturation with and without exposure is used to determine the extent of reproductive toxicity.

Results

We validated our assay using bisphenol A (BPA), a well-established mammalian reproductive toxicant. We find that BPA in yeast has similar detrimental effects in meiosis as shown in worms and mammals. Competition assays with BPA analogs reveal that two of out of 19 BPA analogs examined (bisphenol E and 17β-estradiol) show synergistic effects with BPA at doses tested and none show antagonistic effects. Out of 179 additional environmental chemicals, we designated 57 chemicals as reproductively toxic. Finally, by comparing chemicals in our cohort that have been evaluated for reproductive toxicity in mammalian studies, we find a statistically significant association between toxic chemicals in yeast and mammals.

Conclusion

We show that a high-throughput assay using yeast may be a useful approach for rapidly and reliably identifying chemicals that pose a reproductive risk.
The impact of the COVID-19 pandemic on health service utilisation following self-harm: a systematic review
Authors: Steeg Sarah , John Ann , Gunnell David , Kapur Nav , Dekel Dana , Schmidt Lena , Knipe Duleeka , Arensman Ella , Hawton Keith , Higgins Julian PT , Eyles Emily , Macleod-Hall Catherine , McGuiness Luke A , Webb Roger T
Published: January 2022

Background

Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.

Aims

To systematically review evidence on health services utilisation for self-harm during the COVID-19 pandemic.

Methods

A comprehensive search of multiple databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies reporting presentation frequencies for self-harm published from 1st Jan. 2020 to 7th Sept. 2021 were included. Study quality was assessed using a critical appraisal tool.

Results

Fifty-one studies were included. 59% (30/51) were rated as ‘low’ quality, 29% (15/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51 studies) was from high-income countries. 47% (24/51) of studies reported reductions in presentation frequency, including all 6 rated as high-moderate quality, which reported reductions of 17- 56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the 3 higher quality studies including study observation months from 2021 reported reductions in service utilisation. Evidence from 2021 suggested increased use of health services following self-harm among adolescents, particularly girls.

Conclusions

Sustained reductions in service utilisation were seen into the first half of 2021. However, evidence from low- and middle-income countries is lacking. The increased use of health services among adolescents, particularly girls, into 2021 is of concern. Our findings may reflect changes in thresholds for help seeking, use of alternative sources of support and variable effects of the pandemic across different groups.