bluuebunny/crossref_metadata_2025 huggingface dataset:
Rehabilitation bei Herzinsuffizienz
Authors: Reibis R.K. , Schlitt A. , Langheim E.H. , Guha M. , Halle M. , Boscheri A. , Hegeler-Molkewehrum C. , Völler H.
Published: October 2020

Die Herzinsuffizienz führt jährlich in Deutschland zu
Behandlungskosten in Höhe von >5 Mrd. Euro. Die weltweite
Prävalenz soll in den nächsten 15 Jahren um 25%
zunehmen, und es ist mit einem Anstieg der Krankheitskosten um über
200% zu rechnen. Gründe sind u.a. die Zunahme
kostenintensiver Prozeduren und die Abnahme der
Krankenhausmortalität. Durch das multimodale Programm der
Rehabilitation kann dieser Kreislauf unterbrochen werden.
Social Distancing
Authors: Best Norman
Published: October 2020

Wenn man dieser Tage durch das Internet und die Printmedien
„wildert“, liest man viele Argumente für und gegen das
„social distancing“. Ich finde es müßig, hier
einen weiteren Platz für Argumentationen oder gar Auseinandersetzung
aufzumachen. Diesbezüglich kann ich mir aber ein paar Anmerkungen
dennoch nicht verkneifen.
Aminosäuren und deren Bedeutung für die Gesundheit
Authors: März Henrike
Published: October 2020

Aminosäuren sind hauptsächlich als Eiweißbausteine bekannt, erfüllen jedoch auch wesentliche Aufgaben im Stoffwechsel, da sie als Vorstufen für bedeutende biologische Verbindungen wie Neurotransmitter, Immunfaktoren oder Verdauungsenzyme fungieren. Weil die Stoffwechselwege ineinandergreifen, hängt die Effektivität einzelner Aminosäuren oft von anderen nutritiven Faktoren und einer intakten Enzymfunktion ab. Dies kann bei verschiedenen Erkrankungen von Bedeutung sein. Kenntnisse über Aufgaben, Stoffwechsel und Vorkommen bestimmter Aminosäuren in Nahrungsmitteln ermöglichen eine gezielte Optimierung der Ernährung zur Erhaltung der Gesundheit und unterstützenden Intervention bei Krankheiten.
Competitive Performance of Kenyan Runners Compared to their Relative Body Weight and Fat
Authors: Sengeis Marietta , Müller Wolfram , Störchle Paul , Fürhapter-Rieger Alfred
Published: October 2020

Body fat values obtained with various measurement methods deviate substantially in many cases. The standardised brightness-mode ultrasound method was used in 32 Kenyan elite long-distance runners to measure subcutaneous adipose tissue thicknesses at an accuracy and reliability level not reached by any other method. Subcutaneous adipose tissue forms the dominating part of body fat. Additionally, body mass (m), height (h), sitting height (s), leg length, and the mass index MI1 =0.53m/(hs) were determined. MI1 considers leg length, which the body mass index ignores. MI1 values of all participants were higher than their body mass indices. Both indices for relative body weight were within narrow ranges, although thickness sums of subcutaneous adipose tissue deviated strongly (women: 20–82 mm; men: 3–36 mm). Men had 2.1 times more embedded fasciae in the subcutaneous adipose tissue. In the subgroup with personal best times below world record time plus 10%, no correlation between performance and body mass index was found, and there was also no correlation with sums of subcutaneous adipose tissue thicknesses. Within the data ranges found here, extremely low relative body weight or low body fat were no criteria for the level of performance, therefore, pressure towards too low values may be disadvantageous.
Constructing Russian identity in news translation
Authors: Spiessens Anneleen , Van Poucke Piet
Published: October 2020

In the build-up to the annexation of Crimea in 2014, Russia’s state-owned media pushed a nationalist-imperialist
narrative according to which Crimea is ethnically and historically Russian, and should, therefore, return to the Russian
Motherland. This article underscores the critical role of news translation in the debate around the status of Crimea and in the
circulation of global news, more generally. It focuses on the Russian website InoSMI, a portal that monitors and translates
foreign press, during the peak of the Crimea crisis. Our analysis reveals that Russian translations reframe Western reports in
such a way as to over-emphasize ties between Russia and Crimea. Drawing on both ethnonationalist and imperialist narratives that
capitalize on the place Crimea holds in Russian imagination, and exploiting old metaphors of brotherhood, InoSMI promotes specific
definitions of Russian space and identity that legitimize an aggressive foreign policy.
National Estimates of Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Hospitalized Patients in the United States
Authors: Nelson Richard E , Hatfield Kelly M , Wolford Hannah , Samore Matthew H , Scott R Douglas , Reddy Sujan C , Olubajo Babatunde , Paul Prabasaj , Jernigan John A , Baggs James
Published: October 2020

Background

Treating patients with infections due to multidrug-resistant pathogens often requires substantial healthcare resources. The purpose of this study was to report estimates of the healthcare costs associated with infections due to multidrug-resistant bacteria in the United States (US).

Methods

We performed retrospective cohort studies of patients admitted for inpatient stays in the Department of Veterans Affairs healthcare system between January 2007 and October 2015. We performed multivariable generalized linear models to estimate the attributable cost by comparing outcomes in patients with and without positive cultures for multidrug-resistant bacteria. Finally, we multiplied these pathogen-specific, per-infection attributable cost estimates by national counts of infections due to each pathogen from patients hospitalized in a cohort of 722 US hospitals from 2017 to generate estimates of the population-level healthcare costs in the US attributable to these infections.

Results

Our analysis cohort consisted of 16 676 patients with community-onset infections and 172 712 matched controls and 8246 patients with hospital-onset infections and 66 939 matched controls. The highest cost was seen in hospital-onset invasive infections, with attributable costs (95% confidence intervals) ranging from $30 998 ($25 272–$36 724) for methicillin-resistant Staphylococcus aureus to $74 306 ($20 377–$128 235) for carbapenem-resistant (CR) Acinetobacter. The highest attributable costs for community-onset invasive infections were seen in CR Acinetobacter ($62 396; $20 370–$104 422). Treatment of these infections cost an estimated $4.6 billion ($4.1 billion–$5.1 billion) in 2017 in the US for community- and hospital-onset infections combined.

Conclusions

We found that antimicrobial-resistant infections led to substantial healthcare costs.
Théâtralité et représentation: Rivette revu par Diderot
Authors: Leichman Jeffrey M
Published: October 2020

This article proposes a comparative reading of the role of theatre in the cinema of Jacques Rivette, as seen through the lens of Denis Diderot’s work, looking specifically at the 1984 film
L’Amour par terre
and the 1757 ‘novel’
Le Fils naturel
. The eighteenth-century philosopher interrogates the specificity of theatre — its theatricality — in the context of a hybrid work that seeks to overcome the lack of live spectacle in the printed text by imbricating the dramatic play within a narrative about the ‘real’ lives of characters, in order to illustrate his ideas on the renewal of theatrical art. In turn, Rivette’s cinematic practice poses parallel questions, probing the border between film, condemned to repeat itself, and the theatre (Rivette’s subject of predilection), whose infinite potential for variation comprises its generic signature. In the work of both artists, acting exercises an important influence on the temporality of the narrative, the status of truth, the relationship to images, and the moral value of art. In this way, Rivette and Diderot illustrate the challenges presented by a theatricality at once rejected and embraced by modernity, revealing performance as a crucial tool for exploring the limits of representation.
Independent Side-by-Side Validation and Comparison of 4 Serological Platforms for SARS-CoV-2 Antibody Testing
Authors: Jahrsdörfer Bernd , Kroschel Joris , Ludwig Carolin , Corman Victor Max , Schwarz Tatjana , Körper Sixten , Rojewski Markus , Lotfi Ramin , Weinstock Christof , Drosten Christian , Seifried Erhard , Stamminger Thomas , Groß Hans Jürgen , Schrezenmeier Hubert
Published: October 2020

Highly sensitive and specific platforms for the detection of anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies are becoming increasingly important for evaluating potential SARS-CoV-2 convalescent plasma donors, studying the spread of SARS-CoV-2 infections, and identifying individuals with seroconversion. This study provides a comparative validation of 4 anti–SARS-CoV-2 platforms. A unique feature of the study is the use of a representative cohort of convalescent patients with coronavirus disease 2019 and a mild to moderate disease course. All platforms showed significant correlations with a SARS-CoV-2 plaque reduction neutralization test, with highest sensitivities for the Euroimmun and the Roche platforms, suggesting their preferential use for screening persons at increased risk of SARS-CoV-2 infections.
Hospital medication errors: a cross-sectional study
Authors: ISAACS Anton N , CH’NG Kenneth , DELHIWALE Naaz , TAYLOR Kieran , KENT Bethany , RAYMOND Anita
Published: October 2020

Background

Medication errors (MEs) are among the most common types of incidents reported in Australian and international hospitals. There is no uniform method of reporting and reducing these errors. This study aims to identify the incidence, time trends, types and factors associated with MEs in a large regional hospital in Australia.

Methods

A 5-year cross-sectional study.

Results

The incidence of MEs was 1.05 per 100 admitted patients. The highest frequency of errors was observed during the colder months of May–August. When distributed by day of the week, Mondays and Tuesdays had the highest frequency of errors. When distributed by hour of the day, time intervals from 7 am to 8 am and from 7 pm to 8 pm showed a sharp increase in the frequency of errors. One thousand and eighty-eight (57.8%) MEs belonged to incidence severity rating (ISR) level 4 and 787 (41.8%) belonged to ISR level 3. There were six incidents of ISR level 2 and only one incident of ISR level 1 reported during the five-year period 2014-2018. Administration-only errors were the most common accounting for 1070 (56.8%) followed by prescribing-only errors (433, 23%). High-risk medications were associated with half the number of errors, the most common of which were narcotics (17.9%) and antimicrobials (13.2%).

Conclusions

MEs continue to be a problem faced by international hospitals. Inexperience of health professionals and nurse–patient ratios might be the fundamental challenges to overcome. Specific training of junior staff in prescribing and administering medication and nurse workload management could be possible solutions to reducing MEs in hospitals.
Antivirals With Adjunctive Corticosteroids Prevent Clinical Progression of Early Coronavirus 2019 Pneumonia: A Retrospective Cohort Study
Authors: Ooi Say Tat , Parthasarathy Purnima , Lin Yi , Nallakaruppan Valliammai D/O , Ng Shereen , Tan Teck Choon , Low Serena , Tang Terence
Published: October 2020

This is a retrospective cohort study of hospitalized adults with coronavirus disease 2019 (COVID-19). Fifty-seven patients received treatment alone, and 35 patients received treatment with adjunctive prednisolone. A combination of corticosteroids and antivirals was associated with lower risk of clinical progression and invasive mechanical ventilation or death in early COVID-19 pneumonia.
CP odd weak basis invariants in minimal see-saw model and leptogenesis
Authors: Singh Madan
Published: October 2020

In this paper, we derive the relationship between the weak basis invariants (WB) related to CP violation responsible for leptogenesis and CP violation relevant at low energy. We examine all the experimentally viable cases of Frampton-Glashow and Yanagida (FGY) model, in order to construct the WB invariants in terms of left handed Majorana neutrino mass matrix elements, and thus finding the necessary and sufficient condition for CP conservation. Further for all the viable FGY texture zeros, we have shown the explicit dependence of WB invariants on Dirac type and Majorana type CP violating phases. In the end, we discuss the implication of such interrelationships on leptogenesis.
Maintaining Mobility in a Patient Who Is Pregnant and Has COVID-19 Requiring Extracorporeal Membrane Oxygenation: A Case Report
Authors: Mark Alex , Crumley Jennifer P , Rudolph Kristina L , Doerschug Kevin , Krupp Anna
Published: October 2020

Objective

Mobilization while receiving life support interventions, including mechanical ventilation and extracorporeal membrane oxygenation (ECMO), is a recommended intensive care unit (ICU) intervention to maintain physical function. The purpose of this case report is to describe a novel approach to implementing early mobility interventions for a patient who was pregnant and receiving ECMO while continuing necessary infectious disease precautions because of diagnosed coronavirus disease-19 (COVID-19).

Methods

A 27-year-old woman who was pregnant was admitted to the ICU with COVID-19 and rapidly developed acute respiratory failure requiring 9 days of ECMO support. After a physical therapist consultation, the patient was standing at the bedside by hospital day 5 and ambulating by hospital day 9.

Results

The patient safely participated in physical therapy during ICU admission and was discharged to home with outpatient physical therapy follow-up after 14 days of hospitalization.

Conclusion

Early mobility is feasible during ECMO with COVID-19, and active participation in physical therapy, including in-room ambulation, may facilitate discharge to home. Innovative strategies to facilitate routine activity in a patient who is critically ill with COVID-19 require an established and highly trained team with a focus on maintaining function.

Impact

Early mobility while intubated, on ECMO, and infected with COVID-19 is feasible while adhering to infectious disease precautions when it is performed by an experienced interdisciplinary team.
Keeping Each Other Accountable
Authors: Kenny Jazmine D. , Tsoh Janice Y. , Nguyen Bang H. , Le Khanh , Burke Nancy J.
Published: October 2020

Vietnamese American males have high smoking rates. This study explored social support mechanisms provided by lay health workers (LHWs) and family members through a smoking cessation intervention. Eight focus groups (N = 54) were conducted in Vietnamese stratified by intervention arms (Tobacco [experimental] and healthy living [control]) with 18 smokers, 18 family members, and 18 LHWs. Smokers reported feeling more accountable for their health behaviors, and smoking changes were reinforced by family members, peers, and LHWs through conversations facilitated during and outside the program. Culturally appropriate interventions with multiple social support mechanisms may reduce smoking in minority populations.
Perceived Built Environment and Physical Limitations
Authors: Gayman Mathew D. , Wilkin Holley A. , Stover Shanae , Vidmar Chris M. , Edwards Tiffany , Gallashaw Chandra
Published: October 2020

This study uses primary data from a community-based random sample of adults in historically lower-income African American (or Black) neighborhoods in Atlanta, Georgia (N = 352). The aim was to investigate whether there are race differences in perceived neighborhood conditions/amenities, and the potential conditional effect of race on the relationship between the perceived built environment and physical limitations. Findings indicate significant race differences in the perceived built environment and that the relationship between the perceived built environment and physical limitations is conditioned by race, whereby Whites experience greater physical health benefits from more neighborhood conditions/amenities than African Americans.
Consumers' Ability to Distinguish Between Milk Types
Authors: Glanz Karen , Fenoglio Casey , Quinn Ryan , Karpyn Allison , Paulhamus Giordano Donna
Published: October 2020

The objective of this study was to assess consumers' ability to correctly identify different types of milk in a blind taste test and correlates of plans to purchase lower fat milk. Adults from 8 supermarkets in low-income neighborhoods tasted 3 types of unlabeled lower fat or fat-free milk samples and guessed the type of each sample. Of the 1074 participants, only 7.6% were able to identify all 3 unlabeled samples correctly. Most adults in this study reported consuming higher fat milk and could not correctly identify milk type by taste alone. Blind taste tests may encourage consumers to drink lower fat milk.
THE PROGRESSION OF MACULAR STRUCTURAL AND FUNCTIONAL CHANGES IN LATE-ONSET RETINAL DEGENERATION
Authors: Papastavrou Vasileios T. , O'Brien Jill M. , Regan Aedheen J. , Aftab Akhunzada M. , Browning Andrew C.
Published: October 2020

Background/Purpose:

To characterize the progression of structural and functional changes in the retinas of a small cohort of unrelated patients with early late-onset retinal degeneration and evaluate these changes as potential biomarkers for future treatment trials.

Methods:

Best-corrected visual acuity, contrast sensitivity, Goldman visual fields, retinal sensitivity measurement by mesopic microperimetry, extent of ellipsoid zone disruption using spectral domain optical coherence tomography, and fundus autofluorescence imaging were performed at each biennial visit.

Patients:

Three unrelated patients with molecularly confirmed late-onset retinal degeneration (S163R mutation in C1QTNF5) were prospectively followed for 4 years.

Results:

The patient's ages were 44, 54, and 62 at baseline. Over the 4-year follow-up period, one patient demonstrated a significant reduction in best-corrected visual acuity (6 Early Treatment of Diabetic Retinopathy Study letters), whereas two patients suffered a significant reduction in contrast sensitivity. Early in the disease, there was a close relationship between ellipsoid zone disruption and a loss in retinal sensitivity. Later in the course of the disease, there were areas outside the zones of ellipsoid zone disruption that also suffered progressive loss of retinal sensitivity, suggesting that ellipsoid zone loss was not the only factor responsible for the loss of retinal sensitivity. Changes in fundus autofluorescence and Goldman visual field loss were not closely related to changes in ellipsoid zone disruption or retinal sensitivity loss.

Conclusion:

This study has found that the monitoring of the progression of ellipsoid zone disruption and changes in mesopic microperimetry may be useful biomarkers in future clinical trials in patients with late-onset retinal degeneration.
A New Screening Questionnaire to Identify Patients With Dry Eye With a High Likelihood of Having Sjögren Syndrome
Authors: Bunya Vatinee Y. , Maguire Maureen G. , Akpek Esen K. , Massaro-Giordano Mina , Hennessy Sean , Vivino Frederick B. , Gonzales John A. , Baer Alan N. , Ying Gui-Shuang
Published: October 2020

Purpose:

To develop a screening questionnaire to identify patients with dry eye with a high likelihood of having underlying Sjögren syndrome (SS).

Methods:

This was a cross-sectional study of participants with dry eye complaints who were self-referred or referred by an ophthalmologist to the Sjögren's International Collaborative Clinical Alliance study. Symptoms and ocular surface examination findings were candidate predictors. Univariable and multivariable logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (95% CI) for the association of a symptom and/or ocular sign with SS. Area under the receiver operating characteristic curve (AUC) was used to summarize the predictive ability of different regression models and the derived likelihood score.

Results:

Four questions were statistically significant in the final multivariable model: 1) Is your mouth dry when eating a meal? [Yes = OR 1.63 (1.18–2.26)]; 2) Can you eat a cracker without drinking a fluid or liquid? [No = OR 1.46 (1.06–2.01)]; 3) How often do you have excessive tearing? [None of the time = OR 4.06 (1.81–9.10)]; and 4) Are you able to produce tears? [No = OR 2.24 (1.62–3.09)]. The SS likelihood score had an AUC of 0.70 (95% CI, 0.66–0.73), and when including tear break-up time and conjunctival staining, it yielded an AUC of 0.79 (95% CI, 0.77–0.82).

Conclusions:

This questionnaire can be used to identify patients with dry eye with a high likelihood of having SS. With future refinement and validation, this screening tool could be used alone or in combination with examination findings to identify patients with SS earlier, thereby facilitating better clinical outcomes.
Considerations for Pooled Testing of Employees for SARS-CoV-2
Authors: Schulte Paul A. , Weissman David N. , Luckhaupt Sara E. , de Perio Marie A. , Beezhold Don , Piacentino John D. , Radonovich Lewis J. , Hearl Frank J. , Howard John
Published: October 2020

Objectives:

To identify important background information on pooled tested of employees that employers workers, and health authorities should consider.

Methods:

This paper is a commentary based on the review by the authors of pertinent literature generally from preprints in medrixiv.org prior to August 2020.

Results/Conclusions:

Pooled testing may be particularly useful to employers in communities with low prevalence of COVID-19. It can be used to reduce the number of tests and associated financial costs. For effective and efficient pooled testing employers should consider it as part of a broader, more comprehensive workplace COVID-19 prevention and control program. Pooled testing of asymptomatic employees can prevent transmission of SARS-CoV-2 and help assure employers and customers that employees are not infectious.
Fundal Fluid Cap Is Associated With Hearing Preservation in the Radiosurgical Treatment of Vestibular Schwannoma
Authors: Bojrab Dennis I. , Fritz Christian G. , Lin Kenny F. , Schutt Christopher A. , Hong Robert S. , Babu Seilesh C. , Chen Peter Y. , Maitz Ann , Bojrab Dennis I.
Published: October 2020

Objective:

To evaluate the relationship between fundal fluid and hearing outcomes after treatment of vestibular schwannoma (VS) with Gamma Knife radiosurgery (GKRS).

Study Design:

Retrospective case series.

Setting:

Tertiary neurotology referral center.

Patients:

Patients treated with GKRS for vestibular schwannoma between March 2007 and March 2017 were considered for this study. Exclusion criteria included pretreatment pure-tone average (PTA) >90 dB, neurofibromatosis type II, history of previous surgical resection, and follow-up less than 1 year.

Main Outcome Measure(s):

Hearing function was assessed both by preservation of serviceable hearing and by preservation of baseline hearing (≤20 dB change in PTA) after GKRS. Hearing preservation comparisons were made between groups of patients with and without a fundal fluid cap.

Results:

Patients with a fundal cap had significantly higher rates of baseline hearing preservation (≤20 dB change in PTA) according to Kaplan–Meier survival analysis of all 106 patients (p = 0.006). By the 3rd year posttreatment, 70.9% of patients with a fundal cap had maintained a ≤20 dB change in PTA, while only 43.6% of patients without a fundal fluid cap achieved this outcome (p = 0.004).

Conclusions:

Fundal fluid present on pretreatment magnetic resonance imaging is predictive of improved baseline hearing preservation rates in patients undergoing GKRS for vestibular schwannoma when considering all patients with PTA ≤90 dB. Fundal fluid cap presence may serve as a favorable prognostic indicator to help set hearing expectations and guide patient selection efforts.
Characterizing the Effects of Enchroma Glasses on Color Discrimination
Authors: Bastien Kevin , Mallet Dominique , Saint-Amour Dave
Published: October 2020

SIGNIFICANCE

Enchroma glasses were designed to improve color vision among color-blind individuals. The putative aid of such optic filters in alleviating color blindness remains to be demonstrated. Our study shows that the beneficial impacts on color discrimination are quite small in comparison to the undesirable effects.

PURPOSE

Congenital color blindness is a common genetic anomaly, and there is still no effective aid for affected people. Enchroma glasses are selective filters designed to enhance color discrimination among red-green color-blind individuals. However, there is a lack of data supporting their efficiency. The present study aimed to characterize the effect of Enchroma filters on color discrimination.

METHODS

Colorimetric coordinates of figures from a pseudoisochromatic (American Optical Hardy-Rand-Rittler [AO H-R-R]) test were measured. Nine color-blind and five control adult participants performed the AO H-R-R test and a color-naming task using monochromatic stimuli. All data were collected with and without Enchroma filters.

RESULTS

Colorimetric coordinates of AO H-R-R figures were shifted out of their respective pseudoisochromatic line. The AO H-R-R error scores of participants with color blindness were not clearly improved by the filters except for the protanopic subgroup. However, the filters promoted a change in the classification of the defect, specifically by increasing protan errors in deutan participants. In the color-naming task, Enchroma filters impaired perception in all participants, specifically for cyan stimuli.

CONCLUSIONS

Enchroma filters may affect the nature of a color vision deficiency without necessarily alleviating its severity. Although the performance of protan participants increased in the pseudoisochromatic task with Enchroma filters, this was the only improvement observed across tasks and subgroups. In summary, this study does not support the efficacy of Enchroma filters in correcting color discrimination in color-blind individuals.
Can Protanopia Be Correctly Diagnosed in Clinical Practice? An Evaluation of Diagnosis by Four Screening Tests
Authors: Davison Peter A. , Scanlon Grainne
Published: October 2020

SIGNIFICANCE

Protanopia is a color vision deficiency (CVD) that is unacceptable for certain occupations. This study compares simultaneously for the first time the ability of three recently revised or developed clinical tests of color vision with the Ishihara test to diagnose protanopia from other color vision deficiencies.

PURPOSE

The objectives were to examine the ability of four clinical tests to differentiate (1) between protan and deutan CVDs in patients with protanopia and deuteranopia, and (2) protanopes and deuteranopes as “strong” deficiencies.

METHODS

The Hardy-Rand-Rittler (4th ed.), City University (3rd ed.), Ishihara, and Mollon-Reffin tests were evaluated against the Oculus Heidelberg Multi-Color anomaloscope for 18 protanopes and 9 deuteranopes. Diagnosis by anomaloscopy was subsequent to administration of screening tests.

RESULTS

The Ishihara test misdiagnosed all 18 protanopes as having a deutan deficiency. In contrast, the Hardy-Rand-Rittler and Mollon-Reffin tests correctly identified protan CVD in 100% of protanopes. No screening test was able to reliably diagnose protanopia on the basis of a strong protan CVD.

CONCLUSIONS

The Ishihara test is not suitable for screening for protanopia; its failure to diagnose protanopes as having a protan CVD was far greater than that in previous studies. The Hardy-Rand-Rittler and Mollon-Reffin are the most reliable tests for this purpose. None of the screening tests were able to reliably differentiate dichromacy from strongly anomalous trichromacy.
The Relationship between Pupillometric Values and Visual Evoked Potential Test Results in Patients with Early Glaucoma
Authors: Işik Mehmed Uğur , Şahin Ömer Faruk
Published: October 2020

SIGNIFICANCE

Measuring pupil diameter may provide an additional objective method to detect and monitor glaucoma.

PURPOSE

The purposes of this study were to evaluate whether pupillometry can be used in the assessment of glaucomatous damage and to determine whether pupillometer can be used in glaucoma screening.

METHODS

In this retrospective study, patients with early stages of glaucomatous optic neuropathy were tested using visual evoked potential (VEP), standard automated perimetry, and pupillometer. The VEP record was made using two consecutive check sizes (1° and 15′) at 1-Hz frequency. Patients with a mean deviation of <−2 and >−6 dB were included in the study. Pupil size measurements were performed under photopic conditions at 60-, 100-, and 130-cd/m2luminance levels with the OPD Scan (Nidek, Gamagori, Japan) device.

RESULTS

In all, 24 eyes of 24 patients (14 women and 10 men) with newly diagnosed open-angle glaucoma were included, and 30 eyes of 30 healthy subjects (15 women, 15 men) were used as controls. There was no significant difference between sexes in photopic pupil diameters in either group. Comparing the pupil diameters in different luminance levels, the diameters were significantly larger in the patient group. When age-corrected values in the glaucoma group were compared with an age-matched control group, the differences in P100 latency and amplitudes were statistically significant. There were significant correlations between photopic pupil diameters and timing of VEP waveforms.

CONCLUSIONS

There is a relationship between pupil diameters and VEP results in eyes with early glaucoma.
CORRELATION BETWEEN SARS-COV-2 ANTIBODY SCREENING BY IMMUNOASSAY AND NEUTRALIZING ANTIBODY TESTING
Authors: MENDRONE-JUNIOR ALFREDO , DINARDO CARLA , FERREIRA SUZETE , NISHIA ANNA , SALLES NANCI , ALMEIDA-NETO CESAR , HAMASAKI DEBORA , FACINCANI TILA , ALVES LUCAS , MACHADO RAFAEL , ARAUJO DANIELLE , DURIGON EDISON , ROCHA VANDERSON , SABINO ESTER
Published: October 2020

Background: Passive antibody therapy with convalescent plasma (CP) represents a promising alternative for the treatment of SARS CoV 2 infection. The efficacy of CP therapy has been associated with high titers of neutralizing antibodies (nAbs) in the plasma of recovered patients, but the assays for quantifying nAbs are not widely available. Our goal was to develop a strategy to predict high titers of nAbs based on the results of anti-SARS CoV 2 immunoassays and the clinical characteristics of the CP potential donors.
Methods: Two hundred and fourteen CP donors were enrolled and tested for the presence of anti-SARS CoV 2 antibodies using two commercial immunoassays (IA): Anti SARS CoV 2 ELISA IgG EUROIMMUN and Anti SARS CoV 2 Chemiluminescence IgG Abbott. In parallel, quantification of neutralizing antibodies (nAbs) was performed using the Cytopathic effect-based virus neutralization test (CPE VNT). Three criteria for identifying donors with high titers of nAbs (more than 160) were tested: Criterion1: Curve ROC Method; Criterion 2: Conditional decision tree considering only the results from the IA and Criterion 3: Conditional decision tree including both the IA results and the clinical variables.
Results: The performance of Abbott and EUROIMMUN immunoassays was similar referring to both S/CO and predictive value for identifying nAbs titers more than 1:160. Regarding the three studied criteria for identifying CP donors with high nAbs titers (more than 1:160): 1) Criterion 1 showed 76.1% accuracy when the S/CO cut-off of 4.65 was used, 2) Criterion 2 presented 76.1% accuracy if the S/CO more than 4.57 was applied and 3) Criterion 3 had 71.6% accuracy if either S/CO more than 4.57 or S/CO between 2.68 and 4.57 and the last COVID-19-related symptoms occurred less than 19 days from donor recruiting were used.
Conclusion: The results of SARS-CoV-2 immunoassays (S/CO) can be used to predict high nAbs titers of potential CP donors. This study has proposed three different criteria for identifying donors with more than 160 nAbs titer based on either solely S/CO results or S/CO together with clinical variables, all with high efficacy and accuracy.
Los Angeles County SARS-CoV-2 Epidemic: Critical Role of Multi-generational Intra-household Transmission
Authors: Harris Jeffrey E.
Published: October 2020

We studied the incidence of confirmed COVID-19 cases diagnosed during February 24, 2020 -January 10, 2021 in approximately 300 communities making up Los Angeles County, the largest county by population in the United States. The surge in case incidence observed from October 19 onward, accounting for two-thirds of all confirmed cases, was concentrated in communities with a high prevalence of multi-generational households, as gauged by data from the American Community Survey. This indicator (abbreviated MULTI) was a more important predictor of the surge in incidence than the prevalence of households with low income or with at least one high-risk worker. Serial mapping of the epidemic revealed radial expansion from an initial focus in relatively affluent communities, followed by concentration in high-MULTI communities. This observation was supported by estimates from a spatial adaptation of the SIR model, which yielded a reproductive number of 2.7 for the initial outbreak during February 24 -March 30. With the subsequent flattening of the epidemic curve after the imposition of emergency stay-at-home orders, the global reproductive number fell to 1.0, but with wide local dispersion ranging from 0.6 in low-MULTI communities up to 1.5 in high-MULTI communities. The July 13 state-ordered reversal of the county’s prior decisions to reopen retail stores, indoor dining, hair salons, gyms and bars had a larger negative impact on social mobility in high-MULTI communities, as gauged by data from SafeGraph on smartphone visits to fast-food restaurants. After falling to a low of 0.6, the reproductive number rebounded to 1.4 during the final surge. By the end of the 46-week observation period, the estimated cumulative incidence of COVID-19, adjusted for underascertainment of both asymptomatic and symptomatic cases, ranged from under 10 percent in low-MULTI communities to over 30 percent in high-MULTI communities.
Testing and isolation to prevent overloaded health care facilities and to reduce death rates in the SARS-CoV-2 pandemic in Italy
Authors: Bandyopadhyay Arnab , Schips Marta , Mitra Tanmay , Khailaie Sahamoddin , Binder Sebastian C. , Meyer-Hermann Michael
Published: October 2020

Background

During the first wave of COVID-19, hospital and intensive care unit beds got overwhelmed in Italy leading to an increased death burden. Based on data from Italian regions, we disentangled the impact of various factors contributing to the bottleneck situation of health care facilities, not well addressed in classical SEIR-like models. A particular emphasis was set on the dark figure, on the dynamically changing hospital capacity, and on different testing, contact tracing, quarantine strategies.

Methods

We first estimated the dark figure for different Italian regions. Using parameter estimates from literature and, alternatively, with parameters derived from a fit to the initial phase of COVID-19 spread, the model was optimized to fit data (infected, hospitalized, ICU, dead) published by the Italian Civil Protection.

Results

We showed that testing influenced the infection dynamics by isolation of newly detected cases and subsequent interruption of infection chains. The time-varying reproduction number (Rt) in high testing regions decreased to < 1 earlier compared to the low testing regions. While an early test and isolate (TI) scenario resulted in up to ∼ 32% peak reduction of hospital occupancy, the late TI scenario resulted in an overwhelmed health care system.

Conclusions

An early TI strategy would have decreased the overall hospital accessibility drastically and, hence, death toll (∼ 45% reduction in Lombardia) and could have mitigated the lack of health care facilities in the course of the pandemic, but it would not have kept the hospitalization amount within the pre-pandemic hospital limit. We showed that contact tracing and quarantine without testing would have a similar effect and might be an efficient strategy when sufficient test capacities are not available.
Sepsis Recording in Primary Care Electronic Health Records, Linked Hospital Episodes and Mortality Records: Population-based Cohort Study in England
Authors: Rezel-Potts Emma , Gulliford Martin C. ,   SafeAB Study Group
Published: October 2020

Objectives

Sepsis is a growing concern for health systems, but the epidemiology of sepsis is poorly characterised. We evaluated sepsis recording across primary care electronic records, hospital episodes and mortality registrations.

Methods and Findings

Cohort study including 378 general practices in England from Clinical Practice Research Datalink (CPRD) GOLD database from 2002 to 2017 with 36,209,676 patient-years of follow-up with linked Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality registrations. Incident sepsis episodes were identified for each source. Concurrent records from different sources were identified and age-standardised and age-specific incidence rates compared. Logistic regression analysis evaluated associations of gender, age-group, fifth of deprivation and period of diagnosis with concurrent sepsis recording.

There were 20,206 first episodes of sepsis from primary care, 20,278 from HES and 13,972 from ONS. There were 4,117 (20%) first HES sepsis events and 2,438 (17%) mortality records concurrent with incident primary care sepsis records within 30 days. Concurrent HES and primary care records of sepsis within 30 days before or after first diagnosis were higher at younger or older ages and for patients with the most recent period of diagnosis with those diagnosed during 2007:2011 less likely to have a concurrent HES record given CPRD compared to those diagnosed during 2012 to 2017 (odd ratio 0.65, 95% confidence interval 0.60 to 0.70). At age 85 and older, primary care incidence was 5.22 per 1,000 patient years (95% CI 1.75 to 11.97) in men and 3.55 (0.87 to 9.58) in women which increased to 10.09 (4.86 to 18.51) for men and 7.22 (2.96 to 14.72) for women after inclusion of all three sources.

Conclusion

Explicit recording of sepsis is inconsistent across healthcare sectors with a high proportion of non-concurrent records. Incidence estimates are higher when linked data are analysed.
Comparison of methods for estimating genetic correlation between complex traits using GWAS summary statistics
Authors: Zhang Yiliang , Cheng Youshu , Jiang Wei , Ye Yixuan , Lu Qiongshi , Zhao Hongyu
Published: October 2020

Genetic correlation is the correlation of additive genetic effects on two phenotypes. It is an informative metric to quantify the overall genetic similarity between complex traits, which provides insights into their polygenic genetic architecture. Several methods have been proposed to estimate genetic correlations based on data collected from genome-wide association studies (GWAS). Due to the easy access of GWAS summary statistics and computational efficiency, methods only requiring GWAS summary statistics as input have become more popular than methods utilizing individual-level genotype data. Here, we present a benchmark study for different summary-statistics-based genetic correlation estimation methods through simulation and real data applications. We focus on two major technical challenges in estimating genetic correlation: marker dependency caused by linkage disequilibrium (LD) and sample overlap between different studies. To assess the performance of different methods in the presence of these two challenges, we first conducted comprehensive simulations with diverse LD patterns and sample overlaps. Then we applied these methods to real GWAS summary statistics for a wide spectrum of complex traits. Based on these experiments, we conclude that methods relying on accurate LD estimation are less robust in real data applications compared to other methods due to the imprecision of LD obtained from reference panels. Our findings offer a guidance on how to appropriately choose the method for genetic correlation estimation in post-GWAS analysis in interpretation.
Automated chest radiograph diagnosis: A Twofer for Tuberculosis and Covid-19
Authors: Verma Mitushi , Patkar Deepak , Ingalharikar Madhura , Kharat Amit , Ajmera Pranav , Kulkarni Viraj , Pant Aniruddha , Thakker Vaishnavi , Naik Gunjan
Published: October 2020

Coronavirus disease (Covid 19) and Tuberculosis (TB) are two challenges the world is facing. TB is a pandemic which has challenged mankind for ages and Covid 19 is a recent onset fast spreading pandemic. We study these two conditions with focus on Artificial Intelligence (AI) based imaging, the role of digital chest x-ray and utility of end to end platform to improve turnaround times. Using artificial intelligence assisted technology for triage and creation of structured radiology reports using an end to end platform can ensure quick diagnosis. Changing dynamics of TB screening in the times of Covid 19 pandemic have resulted in bottlenecks for TB diagnosis. The paper tries to outline two types of use cases, one is COVID-19 screening in a hospital-based scenario and the other is TB screening project in mobile van setting and discusses the learning of these models which have both used AI for prescreening and generating structured radiology reports.
Healthcare workers with mild / asymptomatic SARS-CoV-2 infection show T cell responses and neutralising antibodies after the first wave
Authors: Reynolds Catherine J. , Swadling Leo , Gibbons Joseph M. , Pade Corinna , Jensen Melanie P. , Diniz Mariana O. , Schmidt Nathalie M. , Butler David , Amin Oliver E. , Bailey Sasha N. L. , Taylor Stephen , Jones Jessica , Jones Meleri , Jason Lee Wing-Yiu , Rosenheim Joshua , Chandran Aneesh , Joy George , Di Genova Cecilia , Temperton Nigel , Lambourne Jonathan , Cutino-Moguel Teresa , Andiapen Mervyn , Fontana Marianna , Smit Angelique , Semper Amanda , O’Brien Ben , Chain Benjamin , Brooks Tim , Manisty Charlotte , Treibel Thomas , Moon James C ,   COVIDsortium investigators, Noursadeghi Mahdad ,   COVIDsortium immune correlates network, Altmann Daniel M. , Maini Mala K. , McKnight Aine , Boyton Rosemary J.
Published: October 2020

Studies of adaptive immunity to SARS-CoV-2 include characterisation of lethal, severe and mild cases1-8. Understanding how long immunity lasts in people who have had mild or asymptomatic infection is crucial. Healthcare worker (HCW) cohorts exposed to and infected by SARS-CoV-2 during the early stages of the pandemic are an invaluable resource to study this question9-14. The UK COVIDsortium is a longitudinal, London hospital HCW cohort, followed from the time of UK lockdown9,10 ; weekly PCR, serology and symptom diaries allowed capture of asymptomatic infection around the time of onset, so duration of immunity could be tracked. Here, we conduct a cross-sectional, case-control, sub-study of 136 HCW at 16-18 weeks after UK lockdown, with 76 having had laboratory-confirmed SARS-CoV-2 mild or asymptomatic infection. Neutralising antibodies (nAb) were present in 90% of infected HCW sampled after the first wave; titres, likely to correlate with functional protection, were present in 66% at 16-18 weeks. T cell responses tended to be lower in asymptomatic infected HCW than those reporting case-definition symptoms of COVID-19, while nAb titres were maintained irrespective of symptoms. T cell and antibody responses were discordant. HCW lacking nAb also showed undetectable T cells to Spike protein but had T cells of other specificities. Our findings suggest that the majority of HCW with mild or asymptomatic SARS-CoV-2 infection carry nAb complemented by multi-specific T cell responses for at least 4 months after mild or asymptomatic SARS-CoV-2 infection.
Is there a resistance-threshold for macrolide consumption? Positive evidence from an ecological analysis of resistance data from Streptococcus pneumoniae, Treponema pallidum and Mycoplasma genitalium
Authors: Kenyon Chris , Manoharan-Basil Sheeba S. , Van Dijck Christophe
Published: October 2020

Background

If we were to keep macrolide consumption below a certain threshold, would this reduce the probability of macrolide resistance emerging? No study that we are aware of has addressed this question.

Methods

We assessed at a country level if there was a macrolide consumption threshold for the selection of a prevalence of macrolide resistance of over 5% in Streptococcus pneumoniae, Treponema pallidum and Mycoplasma genitalium.

Results

We found evidence for a macrolide consumption threshold of 1.3 defined daily doses per 1000 inhabitants per day (DID) for M. genitalium, 1.8 DID for T. pallidum and 2.3 DID for S. pneumoniae.

Conclusions

Our results provide further motivation for macrolide stewardship campaigns that strive to reduce macrolide consumption to levels below at least 2 DID.
The non-coding RNA miR-17~92 is a central mediator of T cell activation
Authors: Dölz Marianne , Gagnon John D. , Kornete Mara , Marone Romina , Bantug Glenn , Kageyama Robin , Hess Christoph , Ansel K. Mark , Seyres Denis , Roux Julien , Jeker Lukas T.
Published: October 2020

T cell activation is paramount for productive adaptive immune responses. CD28 is a key clinically targeted immunoregulatory receptor because it provides the prototypical costimulatory signal required for T cell activation. Therefore, a precise understanding of the molecular consequences of CD28 costimulation has direct therapeutic relevance. Here, we uncover that the microRNA cluster miR-17~92 is part of the molecular program triggered by CD28 costimulation and hence T cell activation. Combining genetics, transcriptomics, bioinformatics and biochemical miRNA:mRNA interaction maps we demonstrate that transgenic miR-17~92 can cell-intrinsically largely overcome defects caused by CD28-deficiency. miR-17~92 promotes transcription of a proinflammatory gene signature by enhancing the calcineurin/NFAT pathway. miR-17~92 binds to and represses a network of genes including several negative regulators of T cell activation. Finally, CD28-deficient T cells exhibit derepressed miR-17~92 target genes during activation, demonstrating that this non-coding RNA is required to shape the transcriptome. Thus, we propose that miR-17~92 constitutes a central mediator for T cell activation, integrating signals by the TCR and CD28 costimulation. In this model miR-17~92 facilitates T cell activation by dampening the breaks that prevent T cell activation.
Defects in plant immunity modulate the rates and patterns of RNA virus evolution
Authors: Navarro Rebeca , Ambrós Silvia , Butković Anamarija , Carrasco José L. , González Rubén , Martínez Fernando , Wu Beilei , Elena Santiago F.
Published: October 2020

It is assumed that host genetic variability for susceptibility to infection necessarily conditions virus evolution. Differences in host susceptibility can either drive the virus to diversify into strains that track different defense alleles (e.g., antigenic diversity) or to infect only the most susceptible genotypes. To clarify these processes and their effect on virulence, we have studied how variability in host defense responses determine the evolutionary fate of viruses. To accomplish this, we performed evolution experiments withTurnip mosaic potyvirusinArabidopsis thalianamutants. Mutant plants had disruptions in infection-response signaling pathways or in genes whose products are essential for potyvirus infection. Genotypes were classified into five phenogroups according to their response to infection. In order to disentangle how host susceptibility affects virus adaptation, independent viral lineages were evolved in selected plant genotypes. Evaluating disease-related traits of the evolved lineages, we found that evolution proceeded faster in the most resistant hosts than in the most permissive ones, as expected for adaptation to a harsh environment. By sequencing the genomes of the evolved viral lineages, we found that the multifunctional protein VPg turned out to be the target of selection in most host genotypes. When all evolved viral lineages were tested for fitness in all plant genotypes used in the experiments, we found compelling evidences that generalist viruses were selected by the most restrictive plant genotypes, while permissive genotypes selected for specialist viruses. Overall, this work illustrates how different host defense signaling pathways constrain not only disease-related traits but virus evolution.