bluuebunny/crossref_metadata_2025 huggingface dataset:
Hearing Loss in Adults With Alström Syndrome—Experience From the UK National Alström Service
Authors: Quoraishi Sadik , Mason Gemma , Geberhiwot Tarekegn , Dalton Claudia Lucy
Published: June 2022

Objective

To characterize the patterns of hearing loss and methods of hearing rehabilitation in the UK national cohort of adults with Alström syndrome.

Study Design

Retrospective review of electronic patient records.

Setting

UK National multi-disciplinary team (MDT) Alström service held at the Queen Elizabeth Hospital, Birmingham.

Patients

Forty one adult patients with a diagnosis of Alström syndrome, confirmed via ALMS1 gene sequencing, are under ongoing review within the UK National MDT Alström service.

Main Outcome Measures

Magnitude and type of hearing loss were analyzed using patients’ audiometric data. Deterioration of hearing was calculated using serial pure tone audiograms. Methods of hearing rehabilitation used by patients and potential candidacy for cochlear implantation were analyzed.

Results

Of 34 patients with available audiograms, all had sensorineural hearing loss (SNHL). Dual sensory (visual and hearing) loss was present in 32/34 (94%) patients. Hearing deteriorated with advancing age, at 1.23 dB/yr. Severe- profound SNHL was present in 9/34 (26%) cases. Air conduction hearing aids were used in 27/34 (79%) cases, and cochlear implants in 2/34 (5%).

Conclusions

Alström syndrome is an ultra-rare genetic disorder with progressive, debilitating multi-system manifestations, including SNHL. The UK National MDT Alström service represents one of the largest reported adult cohorts in the world. SNHL in this group was ubiquitous, showing a rapid decline in hearing with age. Annual audiometric assessment to enable early diagnosis of hearing loss and optimum rehabilitation are paramount to minimize the impact of hearing loss in this condition.
Statistical Shape Model of the Temporal Bone Using Segmentation Propagation
Authors: Ding Andy S. , Lu Alexander , Li Zhaoshuo , Galaiya Deepa , Ishii Masaru , Siewerdsen Jeffrey H. , Taylor Russell H. , Creighton Francis X.
Published: June 2022

Hypothesis

Automated image registration techniques can successfully determine anatomical variation in human temporal bones with statistical shape modeling.

Background

There is a lack of knowledge about inter-patient anatomical variation in the temporal bone. Statistical shape models (SSMs) provide a powerful method for quantifying variation of anatomical structures in medical images but are time-intensive to manually develop. This study presents SSMs of temporal bone anatomy using automated image-registration techniques.

Methods

Fifty-three cone-beam temporal bone CTs were included for SSM generation. The malleus, incus, stapes, bony labyrinth, and facial nerve were automatically segmented using 3D Slicer and a template-based segmentation propagation technique. Segmentations were then used to construct SSMs using MATLAB. The first three principal components of each SSM were analyzed to describe shape variation.

Results

Principal component analysis of middle and inner ear structures revealed novel modes of anatomical variation. The first three principal components for the malleus represented variability in manubrium length (mean: 4.47 mm; ±2-SDs: 4.03–5.03 mm) and rotation about its long axis (±2-SDs: -1.6° to 1.8° posteriorly). The facial nerve exhibits variability in first and second genu angles. The bony labyrinth varies in the angle between the posterior and superior canals (mean: 88.9°; ±2-SDs: 83.7°–95.7°) and cochlear orientation (±2-SDs: -4.0° to 3.0° anterolaterally).

Conclusions

SSMs of temporal bone anatomy can inform surgeons on clinically relevant inter-patient variability. Anatomical variation elucidated by these models can provide novel insight into function and pathophysiology. These models also allow further investigation of anatomical variation based on age, BMI, sex, and geographical location.
Comparative efficacy trials in inflammatory bowel disease: current and future implications for practice
Authors: Ahuja Dhruv , Singh Siddharth
Published: June 2022

Purpose of review

Over the last decade, there has been rapid expansion of the therapeutic armamentarium, and evolution of treatment strategies, for the management of inflammatory bowel diseases (IBDs). Consequently, there is an increasing need for head-to-head or comparative efficacy trials to inform optimal positioning of therapies, and pragmatic trials comparing treatment strategies to inform treatment approach. In this review, we will discuss the current status and future of comparative efficacy clinical trials in IBD.

Recent findings

Pivotal phase IIIB superiority clinical trials have demonstrated superiority of vedolizumab over adalimumab for achieving clinical remission in patients with moderate-to-severe ulcerative colitis (VARSITY) and failed to demonstrate superiority of ustekinumab over adalimumab in patients with moderate-to-severe Crohn's disease (SEAVUE). Noninferiority clinical trials of biosimilars have confirmed absence of meaningful differences in safety and efficacy of biosimilar infliximab over originator infliximab, as initial therapy or switching stable patients during maintenance. Network meta-analyses, indirect treatment comparison using patient-level data from placebo-controlled trials and real-world observational studies have inform comparative effectiveness and safety of different therapies for management of IBD.

Head-to-head clinical trials are critically important to advance the field of IBD. Comparative efficacy trials are slow and expensive to conduct, may not be broadly generalizable, and are not powered for safety events or other relevant outcomes. Alternative approaches to comparative effectiveness such as network meta-analysis and well designed real-world observational studies are able to bridge gaps in clinical practice.
Mid-term Surgery Outcomes in Patients With COVID-19
Authors: Prasad Nikhil K. , Mayorga-Carlin Minerva , Sahoo Shalini , Englum Brian R. , Turner Douglas J. , Siddiqui Tariq , Lake Rachel , Sorkin John D. , Lal Brajesh K.
Published: June 2022

Objective:

Determine mid-term postoperative outcomes among coronavirus disease 2019 (COVID-19)-positive (+) patients compared with those who never tested positive before surgery.

Background:

COVID-19 is thought to be associated with prohibitively high rates of postoperative complications. However, prior studies have only evaluated 30-day outcomes, and most did not adjust for demographic, clinical, or procedural characteristics.

Methods:

We analyzed data from surgeries performed at all Veterans Affairs hospitals between March 2020 and 2021. Kaplan-Meier curves compared trends in mortality and Cox proportional hazards models estimated rates of mortality and pulmonary, thrombotic, and septic postoperative complications between patients with a positive preoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test [COVID (+)] and propensity score–matched COVID-negative (−) patients.

Results:

Of 153,741 surgical patients, 4778 COVID (+) were matched to 14,101 COVID (−). COVID (+) status was associated with higher postoperative mortality (P<0.0001) with a 6-month survival of 94.2% (95% confidence interval: 93.2–95.2) versus 96.0% (95% confidence interval: 95.7.0–96.4) in COVID (−). The highest mortality was in the first 30 postoperative days. Hazards for mortality and postoperative complications in COVID (+) decreased with increasing time between testing COVID (+) and date of surgery. COVID (+) patients undergoing elective surgery had similar rates of mortality, thrombotic and septic complications, but higher rates of pulmonary complications than COVID (−) patients.

Conclusions:

This is the first report of mid-term outcomes among COVID-19 patients undergoing surgery. COVID-19 is associated with decreased overall and complication-free survival primarily in the early postoperative period, delaying surgery by 5 weeks or more reduces risk of complications. Case urgency has a multiplicative effect on short-term and long-term risk of postoperative mortality and complications.
Intraportal Islet Autotransplantation Independently Improves Quality of Life After Total Pancreatectomy in Patients With Chronic Refractory Pancreatitis
Authors: Chinnakotla Srinath , Beilman Gregory J. , Vock David , Freeman Martin L. , Kirchner Varvara , Dunn Ty B. , Pruett Timothy L. , Amateau Stuart K. , Trikudanathan Guru , Schwarzenberg Sarah J. , Downs Elissa , Armfield Matthew , Ramanathan Karthik , Sutherland David E.R. , Bellin Melena D.
Published: June 2022

Objective:

To determine if islet autotransplantation (IAT) independently improves the quality of life (QoL) in patients after total pancreatectomy and islet autotransplantation (TP-IAT).

Background:

TP-IAT is increasingly being used for intractable chronic pancreatitis. However, the impact of IAT on long-term islet function and QoL is unclear.

Methods:

TP-IAT patients at our center >1 year after TP-IAT with ≥1 Short Form-36 QoL measure were included. Patients were classified as insulin-independent or insulin-dependent, and as having islet graft function or failure by C-peptide. The associations of insulin use and islet graft function with QoL measures were analyzed by using a linear mixed model, accounting for time since transplant and within-person correlation.

Results:

Among 817 islet autograft recipients, 564 patients [median (interquartile range) age: 34 (20, 45) years, 71% female] and 2161 total QoL surveys were included. QoL data were available for >5 years after TP-IAT for 42.7% and for >10 years for 17.3%. Insulin-independent patients exhibited higher QoL in 7 of 8 subscale domains and for Physical Component Summary and Mental Component Summary scores (P<0.05 for all). Physical Component Summary was 2.91 (SE=0.57) higher in insulin-independent patients (P<0.001). No differences in QoL were observed between those with and without graft function, but islet graft failure was rare (15% of patients). However, glycosylated hemoglobin was much higher with islet graft failure.

Conclusions:

QoL is significantly improved when insulin independence is present, and glycosylated hemoglobin is lower with a functioning islet graft. These data support offering IAT, rather than just performing total pancreatectomy and treating with exogenous insulin.
Mental Health Care Following Firearm and Motor Vehicle-related Injuries
Authors: Ehrlich Peter F. , Pulcini Christian D. , De Souza Heidi G. , Hall Matt , Andrews Annie , Zima Bonnie T. , Fein Joel A. , Chaudhary Sofia , Hoffmann Jennifer A. , Fleegler Eric W. , Jeffries Kristyn N. , Goyal Monika K. , Hargarten Stephen W. , Alpern Elizabeth R.
Published: June 2022

Objective:

To compare new mental health diagnoses (NMHD) in children after a firearm injury versus following a motor vehicle collision (MVC).

Background:

A knowledge gap exists regarding childhood mental health diagnoses following firearm injuries, notably in comparison to other forms of traumatic injury.

Methods:

We utilized Medicaid MarketScan claims (2010–2016) to conduct a matched case-control study of children ages 3 to 17 years. Children with firearm injuries were matched with up to 3 children with MVC injuries. Severity was determined by injury severity score and emergency department disposition. We used multivariable logistic regression to measure the association of acquiring a NMHD diagnosis in the year postinjury after firearm and MVC mechanisms.

Results:

We matched 1450 children with firearm injuries to 3691 children with MVC injuries. Compared to MVC injuries, children with firearm injuries were more likely to be black, have higher injury severity score, and receive hospital admission from the emergency department (P<0.001). The adjusted odds ratio (aOR) of NMHD diagnosis was 1.55 [95% confidence interval (95% CI): 1.33–1.80] greater after firearm injuries compared to MVC injuries. The odds of a NMHD were higher among children admitted to the hospital compared to those discharged. The increased odds of NMHD after firearm injuries was driven by increases in substance-related and addictive disorders (aOR: 2.08; 95% CI: 1.63–2.64) and trauma and stressor-related disorders (aOR: 2.07; 95% CI: 1.55–2.76).

Conclusions:

Children were found to have 50% increased odds of having a NMHD in the year following a firearm injury as compared to MVC. Programmatic interventions are needed to address children’s mental health following firearm injuries.
Ruania suaedae sp. nov. and Ruania halotolerans sp. nov., two actinobacteria isolated from saline soil, and reclassification of Haloactinobacterium kanbiaonis as Occultella kanbiaonis comb. nov.
Authors: Xu Lian , Shang Jia , Tian Jing , Sun Ji-Quan , Shen Biao
Published: June 2022

Two Gram-stain-positive, non-motile, strictly aerobic, yellow-coloured, rod-shaped bacterial strains, designated LR1S40T and M4N3S171T, were isolated from rhizosphere and bulk saline soil of Suaeda salsa collected in Inner Mongolia, China. Phylogenetic trees based on 16S rRNA gene and whole genome sequences showed that the two strains clustered tightly with strains of the genus

Ruania

. Strains LR1S40T and M4N3S171T had 95.5% 16S rRNA gene similarity to each other, and strain LR1S40T had 98.8, 98.7, 97.4 and <97.0% similarity to

Ruania alkalisoli

RN3S43T,

Ruania rhizosphaerae

LNNU 22110T,

Ruania alba

YIM 93306T and all other current type strains, while strain M4N3S171T had 98.6 and <97.0% similarity to

R. alba

YIM 93306T, and all other current type strains, respectively. The average nucleotide identity based on blast (ANIb) and digital DNA–DNA hybridization (dDDH) values of LR1S40T and M4N3S171T with each other and to the other type strains of

Ruania

were well below the threshold values (95% for ANIb, 70% for dDDH) for differentiating a species. Diphosphatidylglycerol and phosphatidylglycerol were the major polar lipids in both strains. The predominant menaquinone in both strains was both MK-8. The genome of strain LR1S40T consisted of a 3557440 bp circular chromosome, with a G+C content of 71.1 mol%, while the genome of strain M4N3S171T consisted of 4270413 bp, with a G+C content of 67.6 mol%. The phylogenetic, physiological and phenotypic characteristics allowed discrimination of the two strains from their relatives. The names Ruania suaedae sp. nov. [type strain LR1S40T (=CGMCC 1.19028T=KCTC 49726T)] and Ruania halotolerans sp. nov. [type strain M4N3S171T (=CGMCC 1. 19142T=KCTC 49727T)] are therefore proposed. During the publication of

Haloactinobacterium kanbiaonis

,

Haloactinobacterium glacieicola

(type strain T3246-1T), which was selected as the reference strain for the identification of

H. kanbiaonis

, was reclassified as

Occultella glacieicola

. The two phylogenetic trees showed that

H. kanbiaonis

HY164T tightly clustered with

Occultella aeris

F300T, and had the highest 16S rRNA gene similarity (99.8%) to

O. aeris

F300T. Based on the phylogenetic analysis and the publication record,

Haloactinobacterium kanbiaonis

should be reclassified as Occultella kanbiaonis comb. nov.
Differential and defective transcription of koala retrovirus indicates the complexity of host and virus evolution
Authors: Tarlinton R. E. , Legione A. R. , Sarker N. , Fabijan J. , Meers J. , McMichael L. , Simmons G. , Owen H. , Seddon J. M. , Dick G. , Ryder J. S. , Hemmatzedah F. , Trott D. J. , Speight N. , Holmes N. , Loose M. , Emes R. D.
Published: June 2022

Koala retrovirus (KoRV) is unique amongst endogenous (inherited) retroviruses in that its incorporation to the host genome is still active, providing an opportunity to study what drives this fundamental process in vertebrate genome evolution. Animals in the southern part of the natural range of koalas were previously thought to be either virus-free or to have only exogenous variants of KoRV with low rates of KoRV-induced disease. In contrast, animals in the northern part of their range universally have both endogenous and exogenous KoRV with very high rates of KoRV-induced disease such as lymphoma. In this study we use a combination of sequencing technologies, Illumina RNA sequencing of ‘southern’ (south Australian) and ‘northern’ (SE QLD) koalas and CRISPR enrichment and nanopore sequencing of DNA of ‘southern’ (South Australian and Victorian animals) to retrieve full-length loci and intregration sites of KoRV variants. We demonstrate that koalas that tested negative to the KoRV pol gene qPCR, used to detect replication-competent KoRV, are not in fact KoRV-free but harbour defective, presumably endogenous, ‘RecKoRV’ variants that are not fixed between animals. This indicates that these populations have historically been exposed to KoRV and raises questions as to whether these variants have arisen by chance or whether they provide a protective effect from the infectious forms of KoRV. This latter explanation would offer the intriguing prospect of being able to monitor and selectively breed for disease resistance to protect the wild koala population from KoRV-induced disease.
A critical evaluation of Mycobacterium bovis pangenomics, with reference to its utility in outbreak investigation
Authors: Ceres Kristina M. , Stanhope Michael J , Gröhn Yrjö T.
Published: June 2022

The increased accessibility of next generation sequencing has allowed enough genomes from a given bacterial species to be sequenced to describe the distribution of genes in the pangenome, without limiting analyses to genes present in reference strains. Although some taxa have thousands of whole genome sequences available on public databases, most genomes were sequenced with short read technology, resulting in incomplete assemblies. Studying pangenomes could lead to important insights into adaptation, pathogenicity, or molecular epidemiology, however given the known information loss inherent in analyzing contig-level assemblies, these inferences may be biased or inaccurate. In this study we describe the pangenome of a clonally evolving pathogen,

Mycobacterium bovis

, and examine the utility of gene content variation in

M. bovis

outbreak investigation. We constructed the

M. bovis

pangenome using 1463 de novo assembled genomes. We tested the assumption of strict clonal evolution by studying evidence of recombination in core genes and analyzing the distribution of accessory genes among core monophyletic groups. To determine if gene content variation could be utilized in outbreak investigation, we carefully examined accessory genes detected in a well described

M. bovis

outbreak in Minnesota. We found significant errors in accessory gene classification. After accounting for these errors, we show that

M. bovis

has a much smaller accessory genome than previously described and provide evidence supporting ongoing clonal evolution and a closed pangenome, with little gene content variation generated over outbreaks. We also identified frameshift mutations in multiple genes, including a mutation in glpK, which has recently been associated with antibiotic tolerance in

Mycobacterium tuberculosis

. A pangenomic approach enables a more comprehensive analysis of genome dynamics than is possible with reference-based approaches; however, without critical evaluation of accessory gene content, inferences of transmission patterns employing these loci could be misguided.
Markerless gene editing in Neisseria gonorrhoeae
Authors: Jones Rebekah A. , Yee Wearn Xin , Mader Kahlio , Tang Christoph M. , Cehovin Ana
Published: June 2022

Neisseria gonorrhoeae

, the gonococcus, is a pathogen of major public health concern, but sophisticated approaches to gene manipulation are limited for this species. For example, there are few methods for generating markerless mutations, which allow the generation of precise point mutations and deletions without introducing additional DNA sequence. Markerless mutations are central to studying pathogenesis, the spread of antimicrobial resistance (AMR) and for vaccine development. Here we describe the use of galK as a counter-selectable marker that can be used for markerless mutagenesis in

N. gonorrhoeae

. galK encodes galactokinase, an enzyme that metabolizes galactose in bacteria that can utilize it as a sole carbon source. GalK can also phosphorylate a galactose analogue, 2-deoxy-galactose (2-DOG), into a toxic, non-metabolisable intermediate, 2-deoxy-galactose-1-phosphate. We utilized this property of GalK to develop a markerless approach for mutagenesis in

N. gonorrhoeae

. We successfully deleted both chromosomally and plasmid-encoded genes, that are important for gonococcal vaccine development and studies of AMR spread. We designed a positive-negative selection cassette, based on an antibiotic resistance marker and galK, that efficiently rendered

N. gonorrhoeae

susceptible to growth on 2-DOG. We then adapted the galK-based counter-selection and the use of 2-DOG for markerless mutagenesis, and applied biochemical and phenotypic analyses to confirm the absence of target genes. We show that our markerless mutagenesis method for

N. gonorrhoeae

has a high success rate, and should be a valuable gene editing tool in the future.
An environment to genome control loop using RNA interference processing of secreted tRNAs may regulates the C. elegans chemo-sensory behavior
Authors: Remy Jean-Jacques
Published: June 2022

Alanine tRNAs (UGC) control the development of the innate and the environment-modulated acquired C. elegans chemo-attractive responses. Some Ala-tRNA isomers are required for the development of the chemo-attractive behavior (dev-tRNAs), while others (odor-tRNAs) are made as life-term olfactory imprints of early larval odor-exposures.

dev-tRNAs and odor-tRNAs biosynthesis respectively require the tRNA modifying Elongator complex sub-units ELPC-3 and ELPC-1: while elpc-3 mutants are chemo-attraction deficients, elpc-1 mutants do not synthesize odor-tRNAs imprints.

Feeding wild-type dev-tRNAs restore a wild-type behavior in elpc-3 mutants. Feeding purified odor-tRNAs enhances odor responses (positive imprinting) in adult wild-type worms, while it decreases odor responses (negative imprinting) in adult imprinting deficient elpc-1 mutants.

Both positive and negative imprinting can be stably inherited in worm populations. Crossing experiments indicate that both behavioral phenotypes segregate as monogenic monoallelic alterations, following Mendelian inheritance rules.

Co-culture and food conditioning suggest the developmental and the odor-specific regulatory Ala-tRNAs are released in worms environment. Commensal naive acquire odor-specific imprinting from odor-experienced, while co-culture together with wild-type animals fully rescues the chemo-attractive defects of the elpc-3 mutants.

Worm to worm communication of imprinting require a number of RNA interference (RNAi) genes as the intestinal RNA transporter SID-2, the initial exogenous RNAi Dicer/RDE-1/DRH-1-2/RDE-4 complexe, and the RNA-dependent RNA polymerase RRF-3. Moreover, a male contribution of the 3’-exonuclease ERI-1 activity determines whether olfactory imprints will be erased or stably fixed and inherited in worms progeny.

The RNAi processing of externalized chemosensory regulatory Ala-tRNAs would generate small interfering tRNAs (si-tRNAs) able to target only tRNA complementary sequences present on worm genome, that is the tDNA genes and the transcription independent extra-TFIIIC sites.

A model of control loop in which olfactory receptor expression levels in chemosensory neurons could be non-genetically but stably regulated via RNAi processing of secreted constitutive or environment-modified Ala-tRNAs is discussed.
Inhibitors of ROCK kinases induce multiple mitotic defects and synthetic lethality in BRCA2-deficient cells
Authors: Martino Julieta , Siri Sebastián O. , Paviolo Natalia S. , Garro Cintia , Pansa María F. , Carbajosa Sofía , Brown Aaron C. , Bocco José L. , Gloger Israel , Drewes Gerard , Madauss Kevin P. , Soria Gastón , Gottifredi Vanesa
Published: June 2022

BRCA2-deficient cells are highly sensitive to poly-ADP-ribose polymerase inhibitors (PARPi) due to their impaired homologous recombination repair. This increased cytotoxicity is triggered by DNA replication stress induced by PARP trapping on DNA. Thus, it is broadly assumed that DNA damage is a prerequisite for BRCA2 synthetic lethality (SL). Here we show that inhibiting ROCK kinases in BRCA2 deficient cells, triggers SL independently from acute replication stress. In contrast, such SL is preceded by enhanced M-phase defects such as anaphase bridges, and abnormal mitotic figures, which were associated with multipolar spindles, supernumerary centrosomes and multinucleation. SL was also triggered by inhibiting Citron Rho-interacting kinase, another enzyme which, similarly to ROCK kinases, regulates cytokinesis. Together, these observations suggest cytokinesis failure as trigger of mitotic abnormalities and SL in BRCA2 cells. Furthermore, preventing mitotic entry by Early mitotic inhibitor 1 (EMI1) depletion promoted survival of BRCA2 deficient cells treated with inhibitors of ROCK kinases, thus reinforcing the association between M-phase and the cell death in BRCA2 deficient cells. This novel mechanism of SL induction is in contrast to the one triggered by PARPi and uncovers mitosis as an Achilles heel of BRCA2 deficient cells.
The Math of Margins: A Fresh Look at Bread Loaf Sections, Unchallenged Assumptions, and Citogenesis
Authors: Warne Melissa M. , Klawonn Matthew M. , Brodell Robert T.
Published: June 2022

Although there are many possible ways to treat skin cancer, most skin cancers are effectively treated by complete excision followed by standard histologic evaluation to ensure clear margins. The bread loaf technique describes a common method of processing specimens in which multiple slices of tissue are taken perpendicular to the major axis of an excision and submitted for microscopic analysis. Although sections may only be approximately four microns thick (0.000004 meters), this method is associated with high cure rates for basal cell and squamous cell carcinoma. Some authors have stated that this technique assesses less than 1% of the margins. We critically reviewed this assumption. While we confirm that the bread loaf technique often directly visualizes 1% or less of the peripheral and deep margins when considering only the width of sections compared to the entire length of an excisional specimen of the excision, much useful additional information is gained as soon as clear sections are identified towards the tips of a typical excisional specimen. For tumors that tend to grow in a nodular or spherical arrangement such as nodular basal cell carcinoma or squamous cell carcinoma of keratoacanthomatous type, we show that a variable but significant portion of the margin may be considered sampled by proxy when slice faces are clear. We highlight the importance of understanding the principles involved in tissue sectioning in order to allow clinicians to make informed decisions on behalf of patients.
Non-Adherence of PLWHA in taking Antiretroviral during the COVID-19 pandemic in West Sumatra, Indonesia: Qualitative analysis
Authors: suwito Adriani , ikhwana Ikhwana , usman Elly , widya murni Arina , Hasnita Evi , Indra Rianingsih
Published: June 2022

Abstract
Introduction:
COVID-19 pandemic condition affects the adherence of PLWHA in taking antiretroviral drugs. People with Lost to Follow-up (LTFU) were an average of 26 %, The feared impact is the high mortality rate and decreased productivity, visits of PLWHA patients to M Jamil Hospital come from all regions in West Sumatra to the southern provinces of Jambi and Bengkulu. This study aimed to determine factors that influence patient non-Adherence during the COVID-19 pandemic.
Method:
This study was conducted by exploring the experiences of patients and health workers by observing adherence to taking antiretroviral, 34 informant: 25 patients, 5 NGOs, and 4 health workers, The data were collected from September 6th to October 9th 2021, Analysis data using N VIVO 12.
Results:
Patients in taking medication during the COVID-19 pandemic were feeling bored, most of the patient lived was so far, so patients often asked for help from NGOs to take medication. Forgetfulness, busyness, and fear of being exposed to COVID-19. Then, the economic factor, due to the large number of layoffs, and the absence of BPJS insurance affects compliance, while the factors of stigma, stress, feeling well are slightly expressed by patients. It turns out that the Covid-19 condition affects patients to come for treatment to the hospital. In addition to drug side effects, dizziness, nausea, and vomiting also affect medication adherence. The role of NGOs in providing information and education as well as motivating and taking medication during the COVID-19 condition is very important.
Conclusion:
The most common causes of non-compliance from loss to follow-up during the COVID-19 pandemic are; bored, far from home, forgetful, and economic factors for fear of covid-19. Most of the side effects of drugs are dizziness, and nausea and vomiting so that the role of NGOs is important in helping patients take medication.
Coupling Wastewater-Based Epidemiological Surveillance and Modelling of SARS-COV-2/COVID-19: Practical Applications at the Public Health Agency of Canada
Authors: Joung Meong Jin , Mangat Chand S , Mejia Edgard , Nagasawa Audra , Nichani Anil , Perez-Iratxeta Carol , Peterson Shelley W , Champredon David
Published: June 2022

Wastewater-based surveillance (WBS) of SARS-CoV-2 offers a complementary tool for clinical surveillance to detect and monitor Coronavirus Disease 2019 (COVID-19). Since both symptomatic and asymptomatic individuals infected with SARS-CoV-2 can shed the virus through the fecal route, WBS has the potential to measure community prevalence of COVID-19 without restrictions from healthcare-seeking behaviors and clinical testing capacity. During the Omicron wave, the limited capacity of clinical testing to identify COVID-19 cases in many jurisdictions highlighted the utility of WBS to estimate disease prevalence and inform public health strategies. However, there is a plethora of in-sewage, environmental and laboratory factors that can influence WBS outputs. The implementation of WBS therefore requires a comprehensive framework to outline an analysis pipeline that accounts for these complex and nuanced factors. This article reviews the framework of the national WBS conducted at the Public Health Agency of Canada to present WBS methods used in Canada to track and monitor SARS-CoV-2. In particular, we focus on five Canadian cities – Vancouver, Edmonton, Toronto, Montreal and Halifax – whose wastewater signals are analyzed by a mathematical model to provide case forecasts and reproduction number estimates. This work provides insights on approaches to implement WBS at the national scale in an accurate and efficient manner. Importantly, the national WBS system has implications beyond COVID-19, as a similar framework can be applied to monitor other infectious disease pathogens or antimicrobial resistance in the community.
Efficacy of AI-assisted personalized microbiome modulation by diet in functional constipation: a randomized controlled trial
Authors: Arslan Naciye Çiğdem , Gündoğdu Aycan , Tunali Varol , Topgül Oğuzhan Hakan , Beyazgül Damla , Nalbantoğlu Özkan Ufuk
Published: June 2022

Background

Current medications and behavioral modifications have limited success in the treatment of functional constipation (FC). An individualized diet based on microbiome analysis may improve symptoms in FC. In the present study, we aimed to investigate the impacts of microbiome modulation on chronic constipation.

Methods

Between December 2020 December 2021, 50 patients fulfilling Rome IV criteria for functional constipation were randomized into two groups. The Control group received sodium picosulfate plus conventional treatments (i.e., laxatives, enemas, increased fiber, and fluid intake). The study group underwent microbiome analysis and received an individualized diet with the assistance of a soft computing system (Enbiosis Biotechnology, Sariyer, Istanbul). Differences in Patient Assessment Constipation Quality of Life (PAC QoL) score and complete bowel movements per week (CBMpW) were compared between groups after 6 week intervention.

Results

The mean age of the overall cohort (n= 45) was 31.5 years with 88.9% female predominance. The customized diet developed for subjects on the study arm resulted in a 2.5 fold increase in CBMpW after 6 weeks (1.7 vs. 4.3). The proportion of the study group patients with CBMpW>3 was 83% at the end of the study and the satisfaction score was increased 4 fold from the baseline (3.1 to 10.7 points). More than 50% improvement in PAC-QoL scores was observed in 88% of the study cohort compared to 40% in the control group (p: 0.001).

Conclusion

The AI assisted customized diet based on individual microbiome analysis performed significantly better compared to the conventional therapy based on patient-reported outcomes in the treatment of functional constipation.
The influence of transtibial prosthesis type on gait adaptation: a case study
Authors: Cherni Yosra , Laurendeau Simon , Robet Maxime , Turcot Katia
Published: June 2022

Purpose

Gait parameters are altered and asymmetrical in individual with transtibial amputation. The purpose of this study was to evaluate and compare the effect of four different prosthetic feet on lower-limb biomechanics during gait.

Methods

One young adult with transtibial ampution performed four gait analysis sessions with four foot-ankle prosthesis (Variflex, Meridium, Echelon, Kinterra). Kinematic, kinetic parameters and gait symmetry were analyzed during different prosthesis conditions.

Results

The type of prosthesis had little effect on amputee’ spatiotemporal parameters. Throughout the stance phase, an increase hip angle and a reduced knee flexion and ankle dorsiflexion were observed in the amputated leg. For kinetic parameters, a reduced propulsive force (SI=0.42–0.65), reduced knee extension moment (mainly during Echelon and Kinterra conditions, SI=0.17 and 0.32, respectively) and an increased knee abduction moment (mainly during the Variflex and Meridium, SI=5.74 and 8.93, respectively) in the amputated leg. Lower support moments were observed in the amputated leg compared to the unaffected leg, regardless of the type of prosthesis (SI=0.61–0.80).

Conclusions

The prostheses tested induced different lower-limb mechanical adaptations. If better gait symmetry between lower limbs is one of the clinical goals, an objective gait analysis could help clinicians to prescribe prosthetic feet based on quantitative measurement indicators.
Seed-based connectivity of ventral tegmental area correlates with decreased physical fitness in schizophrenia
Authors: Hamzehpour Lara , Bohn Tamara , Jaspers Lucia , Grimm Oliver
Published: June 2022

Background

Overweight and decreased physical fitness are highly prevalent in schizophrenia, represent a major risk factor for cardio-vascular diseases and decrease the patients’ life expectancies. It is thus important to understand the underlying mechanisms that link psychopathology and weight gain. We hypothesize that the dopaminergic reward system plays an important role in this.

Methods

We analyzed the seed-based functional connectivity (FC) of the ventral tegmental area (VTA) in a group of schizophrenic patients (n = 32) and age- as well as gender matched healthy controls (n = 27). We then correlated the resting-state results with physical fitness parameters, obtained in a fitness test, and psychopathology.

Results

The seed-based connectivity analysis revealed decreased functional connections between the VTA and the anterior cingulate cortex (ACC), as well as the dorsolateral prefrontal cortex and increased functional connectivity between the VTA and the middle temporal gyrus in patients compared to healthy controls. The decreased FC between the VTA and the ACC of the patient group could further be associated with increased body fat and negatively correlated with the overall physical fitness. We found no significant correlations with psychopathology.

Conclusion

Although we did not find significant correlations with psychopathology, we could link decreased physical fitness and high body fat with dysconnectivity between the VTA and the ACC in schizophrenia. These findings demonstrate that a dysregulated reward system is not just responsible for symptomatology in schizophrenia but is also involved in comorbidities and could pave the way for future lifestyle therapy interventions.
Capturing the SARS-CoV-2 infection pyramid within the municipality of Rotterdam using longitudinal sewage surveillance
Authors: de Graaf Miranda , Langeveld Jeroen , Post Johan , Carrizosa Christian , Franz Eelco , Izquierdo-Lara Ray.W. , Elsinga Goffe , Heijnen Leo , Been Frederic , van Beek Janko , Schilperoort Remy , Vriend Rianne , Fanoy Ewout , de Schepper Evelien I.T. , Koopmans Marion P.G. , Medema Gertjan
Published: June 2022

Background

Despite high vaccination rates in the Netherlands, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to circulate. Longitudinal sewage monitoring was implemented along with the notification of cases as two parts of the surveillance pyramid to validate the use of sewage surveillance for monitoring SARS-CoV-2, as an early warning tool, and to measure the effect of interventions.

Methods

Sewage samples were collected from nine neighborhoods from September 2020 to November 2021, and compared with reported cases. Comparative analysis and modeling were performed to understand the correlation between wastewater and case trends.

Findings

Using high resolution sampling, normalization of wastewater SARS-CoV-2 concentrations and ‘normalization’ of reported positive tests for testing delay and intensity, the incidence of reported positive tests could be modeled based on sewage data, and trends in both surveillance systems coincided. The high collinearity implied that high levels of viral shedding around the onset of disease largely determines SARS-CoV-2 levels in wastewater and the observed relation was independent of SARS-CoV-2 variants and vaccination levels.

Interpretation

Wastewater surveillance can accurately display SARS-CoV-2 dynamics for small and large locations, and is sensitive enough to measure small variations in the number of infected individuals within or between neighborhoods. With the transition to a post-acute phase of the pandemic, continued sewage surveillance can help to keep sight on reemergence, but continued “pyramid” validation studies are needed to assess the predictive value of sewage surveillance with new variants.

Funding

Horizon H2020, Adessium Foundation, STOWA, TKI, Ministry of Health, Welfare and Sport
Impact of COVID-19 on the management and outcomes of ureteric stones in the UK: a multicentre retrospective study
Authors: Byrne Matthew H V , Georgiades Fanourios , Light Alexander , Lovegrove Catherine E , Dominic Catherine , Rahman Josephine , Kathiravelupillai Senthooran , Klatte Tobias , Saeb-Parsy Kasra , Kumar Rajeev , Howles Sarah , Stewart Grant D , Turney Ben , Wiseman Oliver
Published: June 2022

Objectives

To determine if management of ureteric stones in the United Kingdom changed during the COVID-19 pandemic and whether this affected patient outcomes.

Patients and methods

We conducted a multicentre retrospective study of adults with CT-proven ureteric stone disease at 39 UK hospitals during a pre-pandemic period (23/3/19 to 22/6/19) and a period during the pandemic (the 3-month period after the first SARS-CoV-2 case at individual sites). The primary outcome was success of primary treatment modality, defined as no further treatment required for the index ureteric stone. Our study protocol was published prior to data collection.

Results

A total of 3735 patients were included (pre-pandemic=1956 patients; pandemic=1779 patients). Stone size was similar between groups (p>0.05). During the pandemic, patients had lower hospital admission rates (pre-pandemic=54.0% vs pandemic=46.5%, p<0.001), shorter length of stay (mean=4.1 vs. 3.3 days, p=0.02), and higher rates of use of medical expulsive therapy (17.4% vs. 25.4%, p<0.001). In patients who received interventional management (pre-pandemic n=787 vs. pandemic n=685), rates of ESWL (22.7% vs. 34.1%, p<0.001) and nephrostomy were higher (7.1% vs. 10.5%, p=0.03); and rates of ureteroscopy (57.2% vs. 47.5%, p<0.001), stent insertion (68.4% vs. 54.6%, p<0.001), and general anaesthetic (92.2% vs. 76.2%, p<0.001) were lower.

There was no difference in success of primary treatment modality between patient cohorts (pre-pandemic=73.8% vs. pandemic=76.1%, P=0.11), nor when patients were stratified by treatment modality or stone size. Rates of operative complications, 30-day mortality, and readmission and renal function at 6 months did not differ between the data collection periods.

Conclusions

During the COVID-19 pandemic, there were lower admission rates and fewer invasive procedures performed. Despite this, there were no differences in treatment success or outcomes. Our findings indicate that clinicians can safely adopt management strategies developed during the pandemic to treat more patients conservatively and in the community.
Strong correlations between the binding antibodies against wild type and neutralizing antibodies against omicron BA.1 and BA.2 variants of SARS-CoV-2 in individuals following booster (third dose) vaccination
Authors: Suntronwong Nungruthai , Assawakosri Suvichada , Kanokudom Sitthichai , Yorsaeng Ritthideach , Auphimai Chompoonut , Thongmee Thanunrat , Vichaiwattana Preeyaporn , Duangchinda Thaneeya , Chantima Warangkana , Pakchotanon Pattarakul , Chansaenroj Jira , Nilyanimit Pornjarim , Srimuan Donchida , Thatsanatorn Thaksaporn , Sudhinaraset Natthinee , Wanlapakorn Nasamon , Mongkolsapaya Juthathip , Poovorawan Yong
Published: June 2022

This study examined the neutralizing activity and receptor binding domain (RBD) antibody levels against wild-type and omicron BA.1 and BA.2 variants in individuals who received three doses of COVID-19 vaccination. The relationship between the SARS-CoV-2 RBD antibody against wild-type and live virus neutralizing antibody titers against omicron BA.1 and BA.2 variants was examined. In total, 310 sera samples from individuals after booster vaccination (third dose) vaccination were tested for specific IgG wild-type SARS-CoV-2 RBD and the omicron BA.1 surrogate virus neutralization test (sVNT). The live virus neutralization assay against omicron BA.1 and BA.2 was performed using the foci-reduction neutralization test (FRNT50). The anti-RBD IgG strongly correlated with FRNT50 titers against BA.1 and BA.2. Non-linear regression showed that anti-RBD IgG with ≥148 BAU/mL and ≥138 BAU/mL were related to detectable FRNT50 titers (≥1:20) against BA.1 and BA.2, respectively. A moderate correlation was observed between the sVNT and FRNT50 titers. At detectable FRNT50 titers (≥1:20), the predicted sVNT for BA.1 and BA.2 were ≥10.57% and ≥11.52%, respectively. The study identified anti-RBD IgG and sVNT levels that predict detectable neutralizing antibodies against omicron variants. Assessment and monitoring of protective immunity support vaccine policies and will help identify optimal timing for booster vaccination.
The association between the incidence of Lyme disease in the United States and indicators of greenness and land cover
Authors: Westra Sydney , Goldberg Mark S. , Didan Kamel
Published: June 2022

Background

Lyme disease is the most common vector-borne illness in the United States. Incidence is related to specific environmental conditions such as temperature, metrics of land cover, and species diversity.

Objective

To determine whether greenness, as measured by the Normalized Difference Vegetation Index (NDVI), and other selected indices of land cover were associated with the incidence of Lyme disease in the northeastern USA, 2000-2018.

Materials and Methods

We conducted an ecological analysis of incidence rates in counties of 15 “high” incidence states and the District of Columbia for 2000-2018. Annual counts of Lyme disease by county were obtained from the US Centers for Disease Control and values of NDVI were acquired from the Moderate Resolution Imaging Spectroradiometer instrument aboard Terra and Aqua Satellites. County-specific values of population density, area of land and water were obtained from the US Census. Using quasi-Poisson regression, multivariable associations were estimated between the incidence of Lyme disease NDVI, land cover variables, human population density, and calendar year.

Results

We found that incidence increased by 7.1% per year (95% confidence interval: 6.8-8.2%). Land cover variables showed complex non-linear associations with incidence: average county-specific NDVI showed a ‘u-shaped” association, the standard deviation of NDVI showed a monotonic upward relationship, population density showed a decreasing trend, areas of land and water showed “n”-shaped relationships. We found an interaction between average and standard deviation of NDVI, with the highest average NDVI category, increased standard deviation of NDVI showed the greatest increase in rates.

Discussion

These associations cannot be interpreted as causal but indicate that certain patterns of land cover may have the potential to increase exposure to infected ticks and thereby may contribute indirectly to increased rates. Public health interventions could make use of these results in informing people where risks may be high.
Hand Dermatitis among Health Care Workers during the COVID-19 Pandemic: Prevalence, and Risk Factors
Authors: Motamed-Rezaei Omolbanin , Sharif-Zadeh Gholamreza , Rajabipour Hadis , Jahani Farnaz , Lotfi Hamed
Published: June 2022

Background

Health care workers (HCWs) need to perform new preventive measures to protect themselves and patients against ongoing COVID-19 transmission, which can increase the occurrence of hand dermatitis (HD) among them.

Objectives

This study aimed to investigate the prevalence of HD among HCWs and its possible risk factors in IRAN.

Methods

A survey of 159 HCWS working in university hospitals was performed between August to September 2020. Research data were collected via the standardized Nordic Occupational Skin Questionnaire (NOSQ-2002).

Results

The prevalence of HD in the study population was 51.6%. Females had a 3.84 fold higher risk of HD than males (confidence interval (CI): 1.85-8). HCWs older than 40 years and those who aged 30-39 years had a 9.6 and 1.72 fold higher risk of HD than HCWs aged 20-29 years (CI: 2.6-35.7; CI: 0.87-3.4, respectively). A significant association was found between the prevalence of HD among HCWs and working hours per week, and wearing gloves (P<0.05).

Conclusion

Possible risk factors for developing HD among HCWs are female gender and older age. Preventive measures for HD are needed for HCWs, especially during the COVID- 19 pandemic.