bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional lung volume mapping with perfusion Single-Photon Emission Computed Tomography scan for radiotherapy planning in patients with locally advanced nonsmall cell lung cancer
Authors: Follacchio Giulia Anna , D’Urso Pasqualina , Cassese Raffaele , Ferrara Carla , Bulzonetti Nadia , Monteleone Francesco , Musio Daniela , Liberatore Mauro , Tombolini Vincenzo
Published: July 2020

Objectives

Radical chemotherapy-radiotherapy represents the standard treatment for locally-advanced nonsmall cell lung cancer (NSCLC). Conventional radiotherapy achieves limited local tumor control, but dose escalation to the primary tumor is prevented by radiotherapy-induced toxicity. The aim of this study was to evaluate feasibility of tailored intensity-modulated radiotherapy (IMRT) planning based on lung single-photon emission computed tomography (SPECT) perfusion data and to compare functional and conventional dose-volume parameters.

Methods

A total of 21 patients were prospectively enrolled. Patients underwent IMRT treatment with 2 Gy/fraction (median total dose of 60 Gy). Lung perfusion SPECT images were acquired before radiotherapy and 3 and 6 months after radiotherapy completion. SPECT and planning computed tomography images were co-registered using MIM-MAESTRO software with 3D-PET Edge algorithm. Lung volumes were defined anatomically as total lung and functionally as total not functional lung and total functional lung. Dose-volume histograms were calculated using QUANTEC constraints [mean lung dose (MLD)<20 Gy, V20<20%]. For each patient, conventional and functional radiotherapy plans were generated and compared.

Results

A total of 19 of 21 patients with NSCLC were included (mean age 66 years, 11 stage IIIA, 8 stage IIIB), 12/19 patients completed the 6-months follow-up. A significant reduction of mean V20 was observed in functional radiotherapy planning compared to conventional plan (405.9 cc, P < 0.001). Mean MLD was also lower in the SPECT-based plans, but the difference was not statistically relevant (0.8 Gy, P = 0.299). G2 radiation pneumonitis was observed in two patients.

Conclusions

Functional radiotherapy planning allowed to decrease functional lung irradiation compared to conventional planning. The possibility to limit radiotherapy-induced toxicity could allow us to perform an effective dose-escalation to target volume.
Sudden Death Due to Neck Paraganglioma
Authors: Abderrahim Sarra Ben , Meddeb Mohamed Ali , Marrakchi Jihene , Besbes Ghazi , Rammah-Rommani Soumaya , Hamdoun Moncef , Khelil Mehdi Ben
Published: July 2020

Neck paragangliomas are relatively rare neuroendocrine nonsecretory tumors. They are mainly observed among adults and are often asymptomatic, causing a frequent delay in diagnosis. In pediatric cases, neck paragangliomas can be associated with adrenergic symptoms that may lead to complications.

A report of a sudden death due to a carotid paraganglioma in a young girl is reported. Autopsy revealed a thoracic arotic dissection and a 4-cm jugulocarotidian mass in the absence of traumatic injuries. Histology showed no evidence of underlying aortic disease, including signs of Marfan syndrome, and a paraganglioma. Postmortem biochemistry analysis showed blood metanephrines levels 100 times higher than normal range. The cause of death was an aortic dissection complicating a neck paraganglioma. The manner of death was concluded as natural.

Our case highlighted the importance for forensic pathologist to consider the diagnosis of paraganglioma in case of sudden hypertensive complications, especially among young people.
A Blueprint for Pediatric Emergency Resource Reallocation During the COVID-19 Pandemic
Authors: Fraymovich Susan , Levine Deborah A. , Platt Shari L.
Published: July 2020

Objective

We present a blueprint for the reallocation of pediatric emergency resources in response to the COVID-19 pandemic.

Methods

New York-Presbyterian Hospital – Weill Cornell Medical Center is an urban, quaternary, academic medical center, a level 1 trauma center, and a regional burn center located in New York City. The novel coronavirus (COVID-19) pandemic created a unique challenge for pediatric emergency medicine. As the crisis heightened for adult patients, pediatric emergency services experienced a significant decline in volume and acuity.

Results

We offer guidelines to modify physical space, clinical services, staffing models, and the importance of steady leadership. Pediatric emergency space was converted to adult COVID-19 beds, necessitating the repurposing of nonclinical areas for pediatric patients. Efficient clinical pathways were created in collaboration with medical and surgical subspecialists for expedited emergency care of children. We transitioned staffing models to meet the changing clinical demands of the emergency department by both reallocation of pediatric emergency medicine providers to telemedicine and by expanding their clinical care to adult patients. Concentrated communication and receptiveness by hospital and department leadership were fundamental to address the dynamic state of the pandemic and ensure provider wellness.

Conclusions

Modification of physical space, clinical services, staffing models, and the importance of steady leadership enabled us to maintain outstanding clinical care for pediatric patients while maximizing capacity and service for adult COVID-19 patients in the emergency department.
Validation of the D:A:D Chronic Kidney Disease Risk Score Model Among People Living With HIV in the Asia-Pacific
Authors: Han Win Min , Bijker Rimke , Chandrasekaran Ezhilarasi , Pujari Sanjay , Ng Oon Tek , Ly Penh Sun , Lee Man-Po , Van Nguyen Kinh , Chan Yu-Jiun , Do Cuong Duy , Choi Jun Yong , Chaiwarith Romanee , Merati Tuti Parwati , Kiertiburanakul Sasisopin , Azwa Iskandar , Khusuwan Suwimon , Zhang Fujie , Gani Yasmin Mohamed , Tanuma Junko , Sangle Shashikala , Ditangco Rossana , Yunihastuti Evy , Ross Jeremy , Avihingsanon Anchalee ,   on behalf of IeDEA Asia-Pacific
Published: July 2020

Background:

We validated the Data collection on Adverse events of anti-HIV Drugs (D:A:D) full-risk and short-risk score models for chronic kidney disease (CKD) in the Asian HIV cohorts.

Settings:

A validation study among people living with HIV (PLHIV) aged ≥18 years among the cohorts in the Asia-Pacific region.

Methods:

PLHIV with a baseline estimated glomerular filtration rate > 60 mL/min/1.73 m2 were included for validation of the D:A:D CKD full version and short version without cardiovascular risk factors. Those with <3 estimated glomerular filtration rate measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan–Meier methods were used to estimate the probability of CKD development. The area under the receiver operating characteristics was also used to validate the risk score.

Results:

We included 5701 participants in full model {median 8.1 [interquartile range (IQR) 4.8–10.9] years follow-up} and 9791 in short model validation [median 4.9 (IQR 2.5–7.3) years follow-up]. The crude incidence rate of CKD was 8.1 [95% confidence interval (CI): 7.3 to 8.9] per 1000 person-years in the full model cohort and 10.5 (95% CI: 9.6 to 11.4) per 1000 person-years in the short model cohort. The progression rates for CKD at 10 years in the full model cohort were 2.7%, 8.9%, and 26.1% for low-risk, medium-risk, and high-risk groups, and 3.5%, 11.7%, and 32.4% in the short model cohort. The area under the receiver operating characteristics for the full-risk and short-risk score was 0.81 (95% CI: 0.79 to 0.83) and 0.83 (95% CI: 0.81 to 0.85), respectively.

Conclusion:

The D:A:D CKD full-risk and short-risk score performed well in predicting CKD events among Asian PLHIV. These risk prediction models may be useful to assist clinicians in identifying individuals at high risk of developing CKD.
Behavioural patterns behind the demise of the commons across different cultures
Authors: Jusup M. , Maciel-Cardoso F. , Gracia-Lázaro C. , Liu C. , Wang Z. , Moreno Y.
Published: July 2020

Common-pool resources require a dose of self-restraint to ensure sustainable exploitation, but this has often proven elusive in practice. To understand why, and characterize behaviours towards ecological systems in general, we devised a social dilemma experiment in which participants gain profit from harvesting a virtual forest vulnerable to overexploitation. Out of 16 Chinese and 15 Spanish player groups, only one group from each country converged to the forest’s maximum sustainable yield. All other groups were overzealous, with about half of them surpassing or on the way to surpass a no-recovery threshold. Computational–statistical analyses attribute such outcomes to an interplay between three prominent player behaviours, two of which are subject to decision-making ‘inertia’ that causes near blindness to the resource state. These behaviours, being equally pervasive among players from both nations, imply that the commons fall victim to behavioural patterns robust to confounding factors such as age, education and culture.
Metric of shock severity
Authors: Yan Yinzhong , Li Q. M.
Published: July 2020

Shock response spectrum (SRS) is a widely accepted method for shock testing specification. However, SRS, as a supremum, is over-conservative and cannot fully describe the relative severity for various shock environments. This study introduces shock response matrix, from which shock severity infimum (SSI) can be extracted using singular value decomposition method. Based on SRS and SSI, dual spectra are introduced to determine the range of shock severity between its supremum and infimum. The evaluation of the relative severity of various shock signals is discussed and validated by finite-element simulations.
Minimum energy bounds on longitudinal elastic constants of transversely isotropic unidirectional composites
Authors: pham Duc-Chinh
Published: July 2020

We consider the
n
-component transversely isotropic unidirectional elastic composites, the longitudinal axis of which is parallel to those of the transversely isotropic components as well as the generators of the cylindrical phase boundaries between them. From the minimum energy and complementary energy principles, with appropriate constant strain and piece-wise constant stress trial fields, optimization and iteration techniques, a set of bounds for the macroscopic (effective) longitudinal elastic constants of the composites (including the simple lower arithmetic average estimate for longitudinal Young modulus
E
eff
 ≥ 
E

V

) are constructed. Numerical examples are provided to illustrate the obtained results.
Low-carbon development via greening global value chains: a case study of Belarus
Authors: Wang Huiqing , Hu Yixin , Zheng Heran , Shan Yuli , Qing Song , Liang Xi , Feng Kuishuang , Guan Dabo
Published: July 2020

The rise of global value chains (GCVs) has seen the transfer of carbon emissions embodied in every step of international trade. Building a coordinated, inclusive and green GCV can be an effective and efficient way to achieve carbon emissions mitigation targets for countries that participate highly in GCVs. In this paper, we first describe the energy consumption as well as the territorial and consumption-based carbon emissions of Belarus and its regions from 2010 to 2017. The results show that Belarus has a relatively clean energy structure with 75% of Belarus' energy consumption coming from imported natural gas. The ‘chemical, rubber and plastic products' sector has expanded significantly over the past few years; its territorial-based emissions increased 10-fold from 2011 to 2014, with the ‘food processing' sector displaying the largest increase in consumption-based emissions. An analysis of regional emissions accounts shows that there is significant regional heterogeneity in Belarus with Mogilev, Gomel and Vitebsk having more energy-intensive manufacturing industries. We then analysed the changes in Belarus' international trade as well as its emission impacts. The results show that Belarus has changed from a net carbon exporter in 2011 to a net carbon importer in 2014. Countries along the Belt and Road Initiative, such as Russia, China, Ukraine, Poland and Kazakhstan, are the main trading partners and carbon emission importers/exporters for Belarus. ‘Construction’ and ‘chemical, rubber and plastic products' are two major emission-importing sectors in Belarus, while ‘electricity' and ‘ferrous metals' are the primary emission-exporting sectors. Possible low-carbon development pathways are discussed for Belarus through the perspectives of global supply and the value chain.
The composition and friction-reducing properties of leaf layers
Authors: Watson Michael , White Benjamin , Lanigan Joseph , Slatter Tom , Lewis Roger
Published: July 2020

Every autumn rail networks across the world suffer delays, accidents and schedule changes due to low friction problems caused by leaves landing on the rails. These leaves form a layer that can reduce the friction between the wheel and the rail to a similar level as that between ice and an ice-skate (

μ
=
0.01
–
0.05

). Previous works have generated several hypotheses for the chemical reactions and low friction mechanism associated with these layers. In this work, the reaction between an aqueous extract of sycamore leaves and metallic iron is investigated. This reaction has been shown to produce a black precipitate, which matches field observations of leaf layers, while friction tests with these extracts produce characteristic ultra low friction. The reaction is investigated through FTIR, XPS, CHNS and ICP-MS analysis as well as wet chemical testing. The impact of the reaction on friction is investigated through three rounds of tribological testing. The results indicate that the black precipitate produced is iron tannate, formed by complexation of tannins with dissolved iron ions. Friction testing showed that eliminating tannins from the leaf extract resulted in a significant increase in the friction coefficient compared with the control.
Fractal solar cell array for enhanced energy production: applying rules underlying tree shape to photovoltaics
Authors: Sim Yeon Hyang , Yun Min Ju , Cha Seung I. , Lee Dong Yoon
Published: July 2020

Plants and photovoltaics share the same purpose as harvesting sunlight. Therefore, botanical studies could lead to new breakthroughs in photovoltaics. However, the basic mechanism of photosynthesis is different to semiconductor-based photovoltaics and the gap between photosynthesis and solar cells must be bridged before we can apply the botanical principles to photovoltaics. In this study, we analysed the role of the fractal structures found in plants in light harvesting based on a simplified model, rotated the structures by 90° and applied them to fractal-structured photovoltaic Si solar cell arrays. Adoption of botanically inspired fractal structures can result in solar cell arrays with omnidirectional properties, and in this case, yielded a 25% enhancement in electric energy production. The fractal structure used in this study was two-dimensional and symmetric; investigating and optimizing three-dimensional asymmetric fractal structures would further enhance the performance of photovoltaics. Furthermore, this study represents only the first step towards the development of a new type of photovoltaics based on botanical principles, and points to further aspects of botanical knowledge that could be exploited, in addition to plant fractal structures. For example, leaf anatomy, phyllotaxis and chloroplastic mechanisms could be applied to the design of new types of photovoltaics.
Collective vibrations of a hydrodynamic active lattice
Authors: Thomson S. J. , Durey M. , Rosales R. R.
Published: July 2020

Recent experiments show that quasi-one-dimensional lattices of self-propelled droplets exhibit collective instabilities in the form of out-of-phase oscillations and solitary-like waves. This hydrodynamic lattice is driven by the external forcing of a vertically vibrating fluid bath, which invokes a field of subcritical Faraday waves on the bath surface, mediating the spatio-temporal droplet coupling. By modelling the droplet lattice as a memory-endowed system with spatially non-local coupling, we herein rationalize the form and onset of instability in this new class of dynamical oscillator. We identify the memory-driven instability of the lattice as a function of the number of droplets, and determine equispaced lattice configurations precluded by geometrical constraints. Each memory-driven instability is then classified as either a super- or subcritical Hopf bifurcation via a systematic weakly nonlinear analysis, rationalizing experimental observations. We further discover a previously unreported symmetry-breaking instability, manifest as an oscillatory–rotary motion of the lattice. Numerical simulations support our findings and prompt further investigations of this nonlinear dynamical system.
Learning on dynamic statistical manifolds
Authors: Boso F. , Tartakovsky D. M.
Published: July 2020

Hyperbolic balance laws with uncertain (random) parameters and inputs are ubiquitous in science and engineering. Quantification of uncertainty in predictions derived from such laws, and reduction of predictive uncertainty via data assimilation, remain an open challenge. That is due to nonlinearity of governing equations, whose solutions are highly non-Gaussian and often discontinuous. To ameliorate these issues in a computationally efficient way, we use the method of distributions, which here takes the form of a deterministic equation for spatio-temporal evolution of the cumulative distribution function (CDF) of the random system state, as a means of forward uncertainty propagation. Uncertainty reduction is achieved by recasting the standard loss function, i.e. discrepancy between observations and model predictions, in distributional terms. This step exploits the equivalence between minimization of the square error discrepancy and the Kullback–Leibler divergence. The loss function is regularized by adding a Lagrangian constraint enforcing fulfilment of the CDF equation. Minimization is performed sequentially, progressively updating the parameters of the CDF equation as more measurements are assimilated.
Vaccinating behaviour guided by imitation and aspiration
Authors: Arefin Md. Rajib , Masaki Tanaka , Tanimoto Jun
Published: July 2020

Vaccinating decisions can be influenced by imitation as well as self-evaluation or aspiration. This work analyses vaccinating behaviours by coupling both imitation and aspiration update rules, adopting an existing set-up of the mean-field vaccination game. We incorporate the imitation mechanism with several variants of the aspiration protocol, encompassing constant and adaptive aspirations. Equations of the combined dynamics have been derived by grouping the population according to (i) vaccinating strategies and (ii) healthy and infected status within each strategy. If aspiration levels are fixed but differentiated by vaccinating strategies, then vaccinators aspiring less than non-vaccinators are found to ameliorate the vaccination coverage, thereby yielding a less infectious state. The adaptive aspirations maintain a positive correlation with the vaccine efficacy while keeping the opposite relation with vaccination cost. When vaccinating strategies, aspirations and update rules are allowed to evolve synchronously, then either the imitation or aspiration process takes over the entire population. If aspiration rules prevail, then vaccinees and non-vaccinees coexist equally (according to (i)) or vaccine uptake follows a non-monotonic trend with the efficacy (according to (ii)). The imitative rule performs better when vaccination is less expensive or cheap, while aspiration updating safeguards the tenacity of vaccinees despite vaccination being expensive.
Effects of partial measurements on quantum resources and quantum Fisher information of a teleported state in a relativistic scenario
Authors: Jafarzadeh M. , Rangani Jahromi H. , Amniat-Talab M.
Published: July 2020

We address the teleportation of single- and two-qubit quantum states, parametrized by weight
θ
and phase
ϕ
parameters, in the presence of the Unruh effect experienced by a mode of a free Dirac field. We investigate the effects of the partial measurement (PM) and partial measurement reversal (PMR) on the quantum resources and quantum Fisher information (QFI) of the teleported states. In particular, we discuss the optimal behaviour of the QFI, quantum coherence (QC) as well as fidelity with respect to the PM and PMR strength and examine the effect of the Unruh noise on optimal estimation. It is found that, in the single-qubit scenario, the PM (PMR) strength at which the optimal estimation of the phase parameter occurs is the same as the PM (PMR) strength with which the teleportation fidelity and the QC of the teleported single-qubit state reaches its maximum value. On the other hand, generalizing the results to two-qubit teleportation, we find that the encoded information in the weight parameter is better protected against the Unruh noise in two-qubit teleportation than in the one-qubit scenario. However, extraction of information encoded in the phase parameter is more efficient in single-qubit teleportation than in the two-qubit version.
Genomic-based taxonomic classification of the family Erythrobacteraceae
Authors: Xu Lin , Sun Cong , Fang Chen , Oren Aharon , Xu Xue-Wei
Published: July 2020

The familyErythrobacteraceae, belonging to the orderSphingomonadales, classAlphaproteobacteria, is globally distributed in various environments. Currently, this family consist of seven genera:Altererythrobacter,Croceibacterium,Croceicoccus,Erythrobacter,Erythromicrobium,PorphyrobacterandQipengyuania. As more species are identified, the taxonomic status of the familyErythrobacteraceaeshould be revised at the genomic level because of its polyphyletic nature evident from 16S rRNA gene sequence analysis. Phylogenomic reconstruction based on 288 single-copy orthologous clusters led to the identification of three separate clades. Pairwise comparisons of average nucleotide identity, average amino acid identity (AAI), percentage of conserved protein and evolutionary distance indicated that AAI and evolutionary distance had the highest correlation. Thresholds for genera boundaries were proposed as 70 % and 0.4 for AAI and evolutionary distance, respectively. Based on the phylo-genomic and genomic similarity analysis, the three clades were classified into 16 genera, including 11 novel ones, for which the namesAlteraurantiacibacter,Altericroceibacterium,Alteriqipengyuania,Alteripontixanthobacter,Aurantiacibacter,Paraurantiacibacter,Parerythrobacter,Parapontixanthobacter,Pelagerythrobacter,TsuneonellaandPontixanthobacterare proposed. We reclassified all species ofErythromicrobiumandPorphyrobacteras species ofErythrobacter. This study is the first genomic-based study of the familyErythrobacteraceae, and will contribute to further insights into the evolution of this family.
Resveratrol and Copper for treatment of severe COVID-19: an observational study (RESCU 002)
Authors: Mittra Indraneel , de Souza Rosemarie , Bhadade Rakesh , Madke Tushar , Shankpal P.D. , Joshi Mohan , Qayyumi Burhanuddin , Bhattacharjee Atanu , Gota Vikram , Gupta Sudeep , Chaturvedi Pankaj , Badwe Rajendra
Published: July 2020

Background

To be universally applicable in treatment of severe COVID-19, novel therapies, especially those with little toxicity and low cost, are urgently needed. We report here the use of one such therapeutic combination involving two commonly used nutraceuticals, namely resveratrol and copper in patients with this disease. This study was prompted by pre-clinical reports that sepsis-related cytokine storm and fatality in mice can be prevented by oral administration of small quantities of resveratrol and copper. Since cytokine storm and sepsis are major causes of death in severe COVID-19, we retrospectively analyzed outcomes of patients with this condition who had received resveratrol and copper.

Methods & Findings

Our analysis comprised of 230 patients with severe COVID-19 requiring inhaled oxygen who were admitted in a single tertiary care hospital in Mumbai between April 1 and May 13 2020. Thirty of these patients received, in addition to standard care, resveratrol and copper at doses of 5.6 mg and 560 ng, respectively, orally, once every 6 hours, until discharge or death. These doses were based on our pre-clinical studies, and were nearly 50 times and 2000 times less, respectively, than those recommended as health supplements. A multivariable-adjusted analysis was used to model the outcome of death in these patients and evaluate factors associated with this event. A binary logistic regression analysis was used, with age, sex, presence of comorbidities and receipt of resveratrol-copper as covariates. Data were updated as of May 30 2020. The number of deaths in resveratrol-copper and standard care only groups were 7/30 (23.3%, 95% CI 8.1%-38.4%) and 89/200 (44.5%, 95% CI 37.6%-51.3%), respectively. In multivariable analysis, age >50 years [odds ratio (OR) 2.558, 95% CI 1.454-4.302, P=0.0011] and female sex (OR 1.939, 95% CI 1.079-3.482, P=0.0267) were significantly associated, while presence of co-morbidities was not significantly associated (OR 0.713, 95% CI 0.405-1.256, P=0.2421) with death. There was a trend towards reduction in death in patients receiving resveratrol-copper (OR 0.413, 95% CI 0.164-1.039, P= 0.0604).

Conclusions

We provide preliminary results of a novel approach to the treatment of severe COVID-19 using a combination of small amounts of commonly used nutraceuticals, which is non-toxic and inexpensive, and therefore could be widely accessible globally. The nearly two-fold reduction in mortality with resveratrol-copper observed in our study needs to be confirmed in a randomized controlled trial.
Divide in Vaccine Belief in COVID-19 Conversations: Implications for Immunization Plans
Authors: Tyagi Aman , Carley Kathleen M.
Published: July 2020

The development of a viable COVID-19 vaccine is a work in progress, but the success of the immunization campaign will depend upon public acceptance. In this paper, we classify Twitter users in COVID-19 discussion into vaccine refusers (anti-vaxxers) and vaccine adherers (vaxxers) communities. We study the divide between anti-vaxxers and vaxxers in the context of whom they follow. More specifically, we look at followership of 1) the U.S. Congress members, 2) four major religions (Christianity, Hinduism, Judaism and Islam), 3) accounts related to the healthcare community, and 4) news media accounts. Our results indicate that there is a partisan divide between vaxxers and anti-vaxxers. We find a religious community with a higher than expected fraction of anti-vaxxers. Further, we find that the variance of vaccine belief within the news media accounts operated by Russian and Iranian governments is higher compared to news media accounts operated by other governments. Finally, we provide messaging and policy implications to inform the COVID-19 vaccine and future vaccination plans.
Baseline Cardiometabolic Profiles and SARS-CoV-2 Risk in the UK Biobank
Authors: Scalsky Ryan J. , Desai Karan , Chen Yi-Ju , O’Connell Jeffery R. , Perry James A. , Hong Charles C.
Published: July 2020

Background

SARS-CoV-2 is a rapidly spreading coronavirus with a high incidence of severe upper respiratory infection that first presented in Wuhan, China in December 2019. Many factors have been identified as risk factors for SARS-CoV-2, with much attention being paid to body mass index (BMI), but little investigation has been done to investigate dysregulation of lipid profiles and diabetes, which are often comorbid in high BMI patients.

Objective

This study seeks to describe the impact of BMI, HDL, LDL, ApoA, ApoB, triglycerides, hemoglobin A1c (HbA1c), diabetes, alcohol and red wine intake on SARS-CoV-2 risk in UK Biobank (UKB) study participants.

Methods

We examined the effect of BMI, lipid profiles, diabetes and alcohol intake on the risk of testing positive for SARS-Cov-2 among 9,005 UKB participants tested for SARS-CoV-2 from March 16 through June 29, 2020. Logistic regression was performed on the target variables controlling for age, sex and ancestry.

Results

BMI, Type II diabetes and HbA1c were associated with increased SARS-CoV-2 risk (p < 0.05) while HDL and ApoA were associated with decreased risk (p < 0.001). Additionally, red wine intake was associated with reduced SARS-CoV-2 risk (p < 0.05). LDL, ApoB and triglyceride levels were not found to be significantly associated with increased risk.

Conclusion

Elevated HDL and ApoA levels and alcohol intake, specifically red wine intake, were associated with reduced risk of testing positive for SARS-CoV-2, while type II diabetes and HbA1c were associated with increased risk. The effects of alcohol, type II diabetes and HbA1c levels may be indirect, mediated in part through regulation of HDL levels. In summary, our study corroborates the emerging picture that high HDL levels may confer protection against SARS-CoV-2.

Highlights

Increases in HDL is associated with reduced risk of testing positive for SARS-CoV-2.

Type II diabetes and hemoglobin A1C levels were associated with elevated risk of testing positive for SARS-CoV-2, but this effect was abrogated when controlling for HDL.

Alcohol intake, specifically red wine intake, is associated with reduced risk of testing positive for SARS-CoV-2, though this effect may in part be moderated by HDL.

LDL and Triglycerides were not associated with increased risk of testing positive for SARS-CoV-2.
Utility and impact of inpatient pediatric physiologic monitoring
Authors: Gourishankar Anand , Evangelista Monaliza , Ellsworth Misti , Hsu Jean
Published: July 2020

Objective

To study the practice and effect of monitoring pediatric patients on the hospital length of stay (LOS).

Methods

We conducted a cross-sectional observational study of pediatric patients in the general ward from October to December 2016. We recorded the use of cardiac, pulse-oximeter, or both, and physician order at the time of admission. We studied the proportions of monitoring on different patient groups. The median length of stay assessed for various modes of monitoring. We did regression analysis for the effect of cardiopulmonary monitoring, orders, and medical complexity on hospital length of stay.

Results

Among 398 patients, patients with cardiac monitor and pulse oximeter with orders were 68 % and 82%, respectively. The pulmonary group of patients had more monitoring than the neurology group of patients. LOS was shorter in patients without monitors; the median difference for the cardiac monitor was 1 day, and pulse oximeter was 0.5 days. Cardiac monitor order increased LOS by 22% (95% CI, 0.5% to 48%) and complex past medical history increased it by 25% (95% CI, 4% to 51%).

Conclusion

Our study highlights the variable practice in using monitors, demanding a standardized approach. The judicious use of monitoring reduces prolonged hospital stay.
Comorbidities associated with regional variations in COVID-19 mortality revealed by population-level analysis
Authors: Yang Hongxing , Zhong Fei
Published: July 2020

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has developed into a global health crisis. Understanding the risk factors for poor outcomes of COVID-19 is thus important for successful management and control of the pandemic. However, the progress and severity of the epidemic across different regions show great differentiations. We hypothesized the origination of these differences are based on location-dependent variations in underlying population-wide health factors. Disease prevalence or incidence data of states and counties of the United States were collected for a group of chronic diseases, including hypertension, diabetes, obesity, stroke, coronary heart disease, heart failure, physical inactivation, and common cancers (e.g., lung, colorectal, stomach, kidney and renal). Correlation and regression analysis identified the prevalence of heart failure as a significant positive factor for region-level COVID-19 mortality. Similarly, the incidence of gastric cancer and thyroid cancer were also identified as significant factors contributing to regional variation in COVID-19 mortality. To explore the implications of these results, we re-analyzed the RNA-seq data for stomach adenocarcinoma (STAD) and colon carcinoma (COAD) from The Cancer Genome Atlas (TCGA) project. We found that expression of genes in the immune response pathways were more severely disturbed in STAD than in COAD, implicating higher probability for STAD patients or individuals with precancerous chronic stomach diseases to develop cytokine storm once infected with COVID-19. Taken together, we conclude that location variations in particular chronic diseases and cancers contribute significantly to the regional variations in COVID-19 mortality.
Exposure to a COVID-19 carrier: transmission trends in respiratory tract and estimation of infectious dose
Authors: Basu Saikat
Published: July 2020

How human respiratory physiology and inhaled airflow therein proceed to impact transmission of SARS-CoV-2, leading to the initial infection, is an open question. An answer can help determine the susceptibility of an individual on exposure to a COVID-2019 carrier and can also quantify the still-unknowninfectious dosefor the disease. Combining computational fluid mechanics-based tracking of respiratory transport in anatomic domains with sputum assessment data from hospitalized COVID-19 patients and earlier measurements of ejecta size distribution during regular speech – this study shows that the regional deposition of virus-laden inhaled droplets at the initial nasopharyngeal infection sites, located in the upper airway, peaks over the droplet size range of 2.5 – 19µ; and reveals that the number of virions that can potentially establish the infection is, at most, of𝒪(102).
Pharmacological and Non-Pharmacological Interventions to Enhance Sleep in Mild Cognitive Impairment and Mild Alzheimer’s Disease: A Systematic Review
Authors: Blackman Jonathan , Swirski Marta , Clynes James , Harding Sam , Leng Yue , Coulthard Elizabeth
Published: July 2020

Suboptimal sleep causes cognitive decline and probably accelerates Alzheimer’s Disease (AD) progression. Several sleep interventions have been tested in established AD dementia cases. However early intervention is needed in the course of AD at Mild Cognitive Impairment (MCI) or mild dementia stages to help prevent decline and maintain good quality of life. This systematic review aims to summarize evidence on sleep interventions in MCI and mild AD dementia.

Seven databases were systematically searched for interventional studies where ≥75% of participants met diagnostic criteria for MCI/mild AD dementia, with a control group and validated sleep outcome measures. Studies with a majority of participants diagnosed with Moderate to Severe AD were excluded.

20164 references were returned after duplication removal. 284 full papers were reviewed with 12 retained. Included papers reported 11 separate studies, total sample (n=602), mean age 76.3 years. Nine interventions were represented: Cognitive Behavioural Therapy – Insomnia (CBT-I), A Multi-Component Group Based Therapy, Phase Locked Loop Acoustic Stimulation, Melatonin, Donepezil, Galantamine, Rivastigmine, Tetrahydroaminoacridine and Continuous Positive Airway Pressure (CPAP). Psychotherapeutic approaches utilising adapted CBT-I achieved statistically significant improvements in the Pittsburgh Sleep Quality Index with one study reporting co-existent improved actigraphy variables. Melatonin significantly reduced sleep latency and sleep to wakefulness transitions in a small sample. CPAP demonstrated efficacy in participants with Obstructive Sleep Apnoea. Evidence to support other interventions was limited.

There is a paucity of evidence for sleep interventions in MCI and mild AD highlighting a pressing need for high quality experimental studies exploring alternative sleep interventions.
Improving Cycle Corrections in Discrete Time Markov Models: A Gaussian Quadrature Approach
Authors: Srivastava Tushar , Strong Mark , Stevenson Matthew D , Dodd Peter J
Published: July 2020

Introduction

Discrete-time Markov models are widely used within health economic modelling. Analyses usually associate costs and health outcomes with health states and calculate totals for each decision option over some timeframe. Frequently, a correction method (e.g. half-cycle correction) is applied to unadjusted model outputs to yield an approximation to an assumed underlying continuous-time Markov model. In this study, we introduce a novel approximation method based on Gaussian Quadrature (GQ).

Methods

We exploited analytical results for time-homogeneous Markov chains to derive a new GQ-based approximation, which is applied to an unadjusted discrete-time model output. The GQ method approximates a continuous-time Markov model result by approximating a correction matrix, formulated as an integral, using a weighted sum of integrand values at specified points. GQ approximations can be made arbitrarily accurate by increasing ‘order’ of the approximation. We compared the first five orders of GQ approximation with four existing cycle correction methods (half-cycle correction, trapezoidal and Simpson’s 1/3 and 3/8 rules) across 100,000 randomly generated input parameter-sets.

Results

We show that first-order GQ method is identical to half-cycle correction method, which is itself equivalent to trapezoidal method. The second-order GQ is identical to Simpson’s 1/3 method. The third, fourth and fifth order GQ methods are novel in this context and provide increasingly accurate approximations to the output of the continuoustime model. In our simulation study, fifth-order GQ method outperformed other existing methods in over 99.8% of simulations. Of the existing methods, Simpson’s 1/3 rule performed the best.

Conclusion

Our novel GQ-based approximation outperforms other cycle correction methods for time-homogeneous models. The method is easy to implement, and R code and an Excel workbook are provided as supplementary materials.
Association of D-dimer and fibrinogen magnitude with hypercoagulability by thromboelastography in severe COVID-19
Authors: Chandel Abhimanyu , Patolia Saloni , Looby Mary , Dalton Heidi J. , Bade Najeebah , Khangoora Vikramjit , Desai Mehul , Lantry James , Osborn Erik , Djurkovic Svetolik , Tang Daniel , Nathan Steven D. , King Christopher S.
Published: July 2020

Introduction

D-dimer concentration has been used to identify candidates for intensified anticoagulant treatment for both venous thromboembolism prevention and mitigation of the microthrombotic complications associated with COVID-19. Thromboelastography (TEG) maximum amplitude (MA) has been validated as an indicator of hypercoagulability and MA ≥ 68 mm has been utilized as a marker of hypercoagulability in other conditions. We evaluated the relationship between coagulation, inflammatory, and TEG parameters in patients with COVID-19 on extracorporeal membrane oxygenation (ECMO).

Methods

We performed a single center retrospective analysis of consecutive patients that received ECMO for the treatment of COVID-19. TEG, inflammatory, and coagulation markers were compared in patients with and without thrombotic complications. Correlation tests were performed to identify the coagulation and inflammatory markers that best predict hypercoagulability as defined by an elevated TEG MA.

Results

168 TEGs were available in 24 patients. C-reactive protein and fibrinogen were significantly higher in patients that developed a thrombotic event versus those that did not (p=0.038 and p=0.043 respectively). D-dimer was negatively correlated with TEG MA (p<0.001) while fibrinogen was positively correlated (p<0.001). A fibrinogen > 441 mg/dL had a sensitivity of 91.2% and specificity of 85.7% for the detection of MA ≥ 68 mm.

Conclusions

In critically ill patients with COVID-19, D-dimer concentration had an inverse relationship with hypercoagulability as measured by TEG MA. D-dimer elevation may reflect severity of COVID-19 related sepsis rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability in this population.
Interaction-based Mendelian randomization with measured and unmeasured gene-by-covariate interactions
Authors: Spiller Wes , Hartwig Fernando Pires , Sanderson Eleanor , Smith George Davey , Bowden Jack
Published: July 2020

Studies leveraging gene-environment (GxE) interactions within Mendelian randomization (MR) analyses have prompted the emergence of two methodologies: MR-GxE and MR-GENIUS. Such methods are attractive in allowing for pleiotropic bias to be corrected when using individual instruments. Specifically, MR-GxE requires an interaction to be explicitly identified, while MR-GENIUS does not. We critically examine the assumptions of MR-GxE and MR-GENIUS, and propose sensitivity analyses to evaluate their performance. Finally, we explore the association between body mass index (BMI) and systolic blood pressure (SBP) using data from the UK Biobank. We find both approaches share similar assumptions, though differences between the approaches lend themselves to differing research settings. Where interactions are identified, MR-GxE relies on weaker assumptions and allows for further sensitivity analyses. MR-GENIUS circumvents the need to identify interactions, but relies on the MR-GxE assumptions holding globally. Through applied analyses we find evidence of a positive effect of BMI upon SBP.
A novel predictive mathematical model for COVID-19 pandemic with quarantine, contagion dynamics, and environmentally mediated transmission
Authors: Barbastefano Rafael , Carvalho Diego , Lippi Maria Clara , Pastore Dayse Haime
Published: July 2020

This work presents an ODE model for COVID-19 named SINDROME that incorporates quarantine, contagion dynamics, and environmentally mediated transmission based on the compartments. The SINDROME model introduces a new parameter that allows environmentally mediated transmission, moving quarantined individuals to the infected compartment. We developed a gray box model with the SINDROME, and fit over 169 regions.
Estimation and correlation of sirtuin1 with Carboxy Methyl Lysine in type 2 diabetic and its microvascular complication
Authors: Mohan Sai Deepika Ram , Nagaraj Shashidhar Kurpad , Anjanappa Raveesha , Chandrappa Muninarayana
Published: July 2020

Background

Increase in Diabetes Mellitus increases incidence of its Microvascular complications such as diabetic retinopathy, diabetic kidney disease (DKD), neuropathy, stroke and cardio vascular diseases (CVD). Advanced glycation end products promotes Type 2 Diabetes to its major Microvascular complication; diabetic kidney disease or diabetic nephropathy leading to increase in expression of sirtuin1; a regulatory protein mediating deacetylation of histone proteins. In addition to diet and nutrition, environmental changes may increase incidence of disorders, one such factor considered in this study is Fluoride.

Objective

Estimation of Sirtuin1 in type 2 diabetes mellitus and diabetic kidney disease and interpreting the outcome by diabetic profiling of patients with controls. Participants: 150 study subjects were recruited for this cross-sectional study divided into 3groups with 50 subjects in each group.

Methods

Diabetic and renal profiling was carried by fully automated analyzer available in our hospital facility, eGFR was calculated, sirtuin1 and CML were measured by ELISA, serum and urine fluoride were estimated by Ion Selective Electrode.

Results

Significant differences observed in FBS, PPBS and CML of deceased with controls. Least median of sirt1 was observed in diabetic nephropathy (36.9). Also, urine and serum fluoride levels were proportionally balanced in group 1& 2 in contrast with group 3 [0.28 (0.2-0.54) & 0.2 (0.15-0.26)].

Conclusion

Decrease in Sirtuin1 in group 3 may be due to chronic hyperglycemia and oxidative stress in diabetes hence, further research on large cohort may aid considering sirtuin1 as a biomarker or therapeutic target in aging disorders.
Nucleation-dependent aggregation kinetics of YeastSup35 fragment GNNQQNY
Authors: Burra Gunasekhar , Maina Mahmoud B. , Serpell Louise C. , Thakur Ashwani K.
Published: July 2020

An N-terminal hepta-peptide sequence of yeast prion protein Sup35 with the sequence GNNQQNY serves as an ideal model for structural understanding of amyloid assembly and kinetics. In this study, we used a reproducible solubilisation protocol that allows the generation of homogenous monomeric solution of GNNQQNY to understand the molecular details of its self-assembly mechanism. The aggregation kinetics data show that the GNNQQNY sequences follow nucleation-dependent aggregation kinetics with a critical nucleus of size ~7 monomers and that the size and efficiency of nucleation was found to be inversely related to the reaction temperature. The generated nucleus reduces the thermodynamic energy barrier by acting as a template for further self-assembly and results in highly ordered amyloid fibrils. The fibers grown at different temperatures showed similar Thioflavin T positivity, Congo red binding and β-sheet rich structures displaying a characteristic cross-β diffraction pattern. These aggregates also share morphological and structural identity with those reported earlier. The mature GNNQQNY fibers exerted no significant oxidative stress or cytotoxicity upon incubating with differentiated SHSY5Y cells. To our knowledge, this is the first study to experimentally validate previous predictions based on theoretical and molecular dynamics simulations. These findings will provide the basis for understanding the kinetics and thermodynamics of amyloid nucleation and elongation of amyloidogenic systems associated with many systemic and neurodegenerative diseases.
COCO-Search18: A Dataset for Predicting Goal-directed Attention Control
Authors: Chen Yupei , Yang Zhibo , Ahn Seoyoung , Samaras Dimitris , Hoai Minh , Zelinsky Gregory
Published: July 2020

Attention control is a basic behavioral process that has been studied for decades. The currently best models of attention control are deep networks trained on free-viewing behavior to predict bottom-up attention control—saliency. We introduce COCO-Search18, the first dataset of laboratory-qualitygoal-directed behaviorlarge enough to train deep-network models. We collected eye-movement behavior from 10 people searching for each of 18 target-object categories in 6202 natural-scene images, yielding∼300,000 search fixations. We thoroughly characterize COCO-Search18, and benchmark it using three machine-learning methods: a ResNet50 object detector, a ResNet50 trained on fixation-density maps, and an inverse-reinforcement-learning model trained on behavioral search scanpaths. Models were also trained/tested on images transformed to approximate a foveated retina, a fundamental biological constraint. These models, each having a different reliance on behavioral training, collectively comprise the new state-of-the-art in predicting goal-directed search fixations. Our expectation is that future work using COCO-Search18 will far surpass these initial efforts, finding applications in domains ranging from human-computer interactive systems that can anticipate a person’s intent and render assistance to the potentially early identification of attention-related clinical disorders (ADHD, PTSD, phobia) based on deviation from neurotypical fixation behavior.