bluuebunny/crossref_metadata_2025 huggingface dataset:
Timing of COVID-19 Vaccine Approval and Endorsement by Public Figures
Authors: Bokemper Scott E. , Huber Gregory A. , Gerber Alan S. , James Erin K. , Omer Saad B.
Published: October 2020

The global spread of COVID-19 has created an urgent need for a safe and effective vaccine. However, even if a safe and medically effective vaccine is developed, hesitancy by citizens to receive it would undercut its effectiveness as a tool for limiting the spread of COVID-19.1,2,3 A potential driver of hesitancy in the United States is the politicization of a potential vaccine, including when one might be approved with respect to the presidential election and which public figures are endorsing its safety and efficacy.4,5 Using a pair of randomized survey experiments, we show that announcing approval of a COVID-19 vaccine one week before the election compared to one week after considerably reduces both beliefs about its safety and efficacy and willingness to receive it. However, endorsement by Dr. Anthony Fauci increases reported beliefs about safety and willingness to receive a vaccine among all partisan subgroups. Further, an endorsement by Dr. Fauci increased uptake and confidence in safety even if a vaccine receives pre-election approval. The results here suggest that perceptions of political influence in COVID-19 vaccine approval could significantly undermine the viability of a vaccine as a strategy to end the pandemic.
Identification of key genes associated with Idiopathic Pulmonary Fibrosis by combining multiple analytical methods
Authors: Zhao Yong , Yang Shengnan , Dong Weigang , Li Yuechuan , Feng Jing
Published: October 2020

Idiopathic Pulmonary Fibrosis (IPF) is the most common type of idiopathic interstitial pneumonias (IIPs) with unclear etiology and lack of effective diagnostic biomarker or therapeutic targets. This study aimed to identify the key genes associated with IPF through multiple microarray datasets. two datasets including GSE32537 and GSE110147 retrieved from Gene Expression Omnibus (GEO) database were used as training dataset (N =169) and external validation dataset (N =33). A total of 365 differentially expressed genes (DEGs) were identified between normal tissue and IPF tissue in the training dataset. Function enrichment analysis result indicated that these genes were involved in cell proliferation, response to stimulus, cellular process and immune system process. We then constructed a protein-protein network (PPI) using the cytoscape software based on the DEGs and the hub modules were screened using the MCODE algorithm. Then the DEGs from hub modules were further exploited into Least absolute shrinkage and selection operator (LASSO) and support vector machine (SVM) analysis in the training dataset. 13 key genes including SERPIND1, CDH2, CP, WDR63, DNAH5, FGG, THBS1, VCAM1, COL1A2, POSTN, CXCL12, MMP13, SERPINE1 were further validated in the validation dataset. In addition, we also applied the CIBERSORT algorithm to evaluate the infiltration level of immune cells in IPF tissue, and the correlation between key genes and infiltrating immune cells. We identified that Plasma cells, CD4 naive T cells, NK resting cells, Monocytes, Mast resting cells and Neutrophils might involved in the process of IPF. Moreover, we also identified several drugs including pregnenolone, indoprofen, ramipril, inburnine may contribute to the treatment of IPF. In conclusion, the 13 genes might serve as potential diagnostic markers of IPF, and the immune cell infiltration plays an essential role in the occurrence and progression of IPF.
A characteristic turning point between summer and autumn in north China
Authors: Xie Yaoqin
Published: October 2020

It is generally believed that seasonal alternation is a gradual process marked by temperature. Explored from a large data set containing 1,686,528 data points of temperature, humidity and sunshine duration, we established a seasonal dynamic model of north China. Based on the model, we discovered a turning point on the 220th day in the annual average distribution of humidity and sunshine duration, which can be used as a characteristic node to define the date of summer-autumn alternation in north China. Our results demonstrate that the alternation of summer and autumn is not a gradual process in this region, but a mutation in the annual distributions of humidity and sunshine duration, thus revealing the statistical invariance based on the local knowledge. The study also shows that humidity and sunshine duration can better reflect the climate characteristics of north China than temperature. Because the model is region-specific, the proposed method using big data can be further extended to quantitatively define other seasonal alternations and explore other climate characteristics in different regions, so as to benefit indigenous knowledge-based climate prediction.
A Qualitative Analysis of Factors Related to Unsafe Work Behaviors Among Environmental Service Workers in the COVID-19 Era: Perspectives of Workers, and Safety Managers: The Case of Government Hospitals in Addis Ababa, Ethiopia.
Authors: Tamene Aiggan
Published: October 2020

Background: The Environmental service profession is hazardous, partially because of the work's inherently dangerous nature. Thus, injuries, accidents, and illnesses result in substantial financial and social losses. The most common immediate cause of these work-related incidents is unsafe work-behavior; the first step in taking steps to prevent unsafe behavior is to recognize the factors promoting it. The goal of this study was to (a) investigate the attitudes and perceptions of safety among the employees and safety managers of Coronavirus treatment hospitals in Addis Ababa, Ethiopia and (b) identify the factors that inhibit safe work behaviors.Methods: Two qualitative data collection approaches, namely key informant interviews and individual in-depth interviews, were used to collect data for this study. Twenty-five participants were recruited from three Coronavirus treatment facilities using a modified convenience sampling strategy, and interviews were conducted to gain a detailed understanding of factors that serve as barriers to safe work behavior. The interviews were recorded and transcribed in Amharic (the local language) and then translated into English. Open Code 4.02 was used for thematic analysis.Results: Poor safety management and supervision, unsafe work environment, and perceptions, skills, and training level of employees were established as the major factors associated with the prevailing unsafe work behavior among environmental service employees.Conclusions: The present study showed that different types of personal and environmental factors may discourage safe work behavior among environmental service workers. To minimize or remove these risk factors for unsafe behaviors, the individual's obligation is important, but the role of management is critical in providing resources for safe work behavior.
Nose ‐To ‐Brain Delivery of Mitochondria for Treatment of Parkinson’s Disease Model Rats With 6-Hydroxydopamine
Authors: Chang Jui-Chih , Chao Yi-Chun , Chang Huei-Shin , Wu Yu-Ling , Chang Hui-Ju , Lin Yong-Shiou , Cheng Wen-Ling , Lin Ta-Tsung , Liu Chin-San
Published: October 2020

BackgroundFeasibility of mitochondrial organelle transport via the olfactory bulb route for Parkinson's disease (PD) therapy was evaluated in the unilateral 6-OHDA-lesioned rats due to the distinct difference based on payload properties. MethodsAn intranasal infusion with 200 μg of allogeneic mitochondria conjugated with Pep-1 (P-Mito) or not (Mito) was executed once a week at the ipsilateral side of lesioned brain for three months of treatments.Results A significant improvement of rotational and locomotor behaviors in PD rats was found in both mitochondria-treating groups in contrast to Sham group or Pep-1 group. There was more than 60% recovery survival of dopaminergic (DA) neurons in substantia nigra (SN) and striatum (ST) of lesioned sides compared to the intact sides in groups of Mito and P-Mito. Treatment effect in P-Mito group was higher in the P-Mito group than Mito group but not significant. The mechanism was associated with the restoration of mitochondrial function and attenuation of oxidative damage in lesioned SN. Notably, Pep-1 modification suppressed the plasma level of inflammatory cytokines induced by infused mitochondria. The 5-bromo-2-deoxyuridine-labelled tracks showed the mitochondrial penetrating into doublecortin-positive neurons of rostral migratory stream (RMS) along with the accessory olfactory bulb in ipsilateral side of lesion and it was expressed in striatal DA neurons, but not in SN, of two cerebral hemispheres via commissural fibers. Conclusion This study showed a promising approach of nose-to-brain delivery for mitochondrial transplantation by confirming the mitochondrial internalization via RMS neurons migration in olfactory bulb for therapeutic action of PD in rats.
A Principal Components Analysis of Factors Associated with Successful Implementation of an LVAD Decision Support Tool
Authors: Kostick Kristin M. , Trejo Meredith , Bhimaraj Arvind , Civitello Andrew , Grinstein Jonathan , Horstmanshof Douglas , Jorde Ulrich P. , Loebe Matthias , Mehra Mandeep R. , Sulemanjee Nasir Z. , Thohan Vinay , Trachtenberg Barry H. , Uriel Nir , Volk Robert J. , Estep Jerry D. , Blumenthal-Barby J. S.
Published: October 2020

Background: A central goal among researchers and policy makers seeking to implement clinical interventions is to identify key facilitators and barriers that contribute to implementation success. Despite calls from a number of scholars, empirical insights into the complex structural and cultural predictors of why DAs become routinely embedded in health care settings remains limited and highly variable across implementation contexts.Methods: We examined associations between “reach”, a widely used indicator (from the RE-AIM model) of implementation success, and multi-level site characteristics of nine LVAD clinics engaged over 18 months in implementation and dissemination of a decision aid for left-ventricular assist device (LVAD) treatment. Based on data collected from nurse coordinators, we explored factors at the level of the organization (e.g. patient volume), patient population (e.g. health literacy; average sickness level), clinician characteristics (e.g. attitudes towards decision aid; readiness for change) and process (how the aid was administered). We generated descriptive statistics for each site and calculated zero-order correlations (Pearson’s r) between all multi-level site variables including cumulative reach at 12 months and 18 months for all sites. We used principal components analysis (PCA) to examine any latent factors governing relationships between and among all site characteristics, including reach.Results: We observed strongest inclines in reach of our decision aid across the first year, with uptake fluctuating over the second year. Average reach across sites was 63% (s.d.=19.56) at 12 months and 66% (s.d.=19.39) at 18 months. Our (PCA) revealed that site characteristics positively associated with reach on two distinct dimensions, including a first dimension reflecting greater organizational infrastructure and standardization (characteristic of larger, more established clinics) and a second dimension reflecting positive attitudinal orientations, specifically, openness and capacity to give and receive decision support among coordinators and patients.Conclusions: Successful implementation plans should incorporate specific efforts to promote supportive and mutually informative interactions between clinical staff members and to institute systematic and standardized protocols to enhance the availability, convenience and salience of intervention tool in routine practice. Further research is needed to understand whether “core predictors” of success vary across different intervention types.
Comparison of Prognostic Models of Spontaneous Intracerebral Hemorrhage: Potential Tools for Personalized Care and Clinical Trial in ICH
Authors: JI RUIJUN , WANG WENJUAN , LIU XINYU , WANG LINLIN , JIANG RUIXUAN , ZHANG RUNHUA , WANG DANDAN , JIA JIAOKUN , FENG HAO , DING ZEYU , LIU YANFANG , LIU GAIFEN , LU JINGJING , JU YI , ZHAO XINGQUAN
Published: October 2020

Background: Several prognostic models have been developed for spontaneous intracerebral hemorrhage (ICH); however, none of them have been consistently used in routine clinical practice or clinical research. In the study, we systematically compared 27 ICH models with regard to mortality and functional outcome at 1-month, 3-month and 1-year after ICH. Methods: The validation cohort was derived from the Beijing Registration of Intracerebral Hemorrhage. Poor functional outcome was defined as modified Rankin Scale score (mRS) ≥3 at 1-month, 3-month and 1-year after ICH, respectively. The area under the receiver operating characteristic curve (AUROC) and Hosmer-Lemeshow goodness-of-fit test were used to assess model discrimination and calibration. Moderate, good, excellent and outstanding discrimination were predefined as AUROC of 0.75-0.79, 0.80-0.84, 0.85-0.89 and above 0.90, respectively.Results: A total number of 1575 patients were included. The mean age was 57.2±14.3 and 67.2% were male. The median NIHSS score on admission was 11 (IQR: 3-21). For predicting mortality at 3-month after ICH, AUROC of 27 ICH models ranged from 0.604 to 0.856. One model showed excellent discrimination; fifteen models demonstrated good discrimination; and seven models demonstrated moderate discrimination. In pairwise comparison, the ICH-FOS (0.856, 95%CI=0.835-0.878, P<0.001) showed statistically better discrimination than other models for mortality at 3-month after ICH (all P<0.05). For predicting poor functional outcome (mRS≥3) at 3-month after ICH, AUROC of 27 ICH models ranged from 0.602 to 0.880. Five models showed excellent discrimination; six models demonstrated good discrimination; and ten models demonstrated moderate discrimination. In pairwise comparison with other prediction models, the ICH-FOS was superior in predicting poor functional outcome at 3-month after ICH (all P<0.001). Several risk models were well calibrated (Hosmer-Lemeshow test P>0.05) for mortality and poor functional outcome at 3-month after ICH, however, the ICH-FOS showed the largest Cox and Snell R-square. Similar results were verified for mortality and poor functional outcome at 1-month and 1-year after ICH. Conclusion: Several risk models are externally validated to be effective for risk stratification and outcome prediction after ICH, especially the ICH-FOS, which would be useful tools for personalized care and clinical trial in ICH.
Sustained Down Regulation of Plasma Tetranectin Contributes to Liver Injury in Pneumonia-Associated Sepsis
Authors: Wang Shuaiwei , Bai Yu , Guo Yu , Bai Qing , Wei Xiangyan , Zhang Yijie , Chen Na , Miller Edmund J. , Li Wei
Published: October 2020

Background: It was recently shown that tetranectin (TN) concentration in the plasma of sepsis patients was significantly lower than healthy control and that exogenous TN reduced the mortality rate in septic mice. The aim of this study is to determine whether the reduction of plasma TN is a sepsis-specific host response and its impact on organ dysfunction in sepsis.Methods: The study was conducted in the Sepsis Laboratory at the Huaihe Hospital of Henan University in China. Thirty-seven healthy, 30 community-acquired pneumonia (CAP) and 363 sepsis with comorbid pneumonia (SWP) subjects were recruited. A murine model of polymicrobial sepsis was used to characterize the role of plasma TN in sepsis pathogenesis.Results: TN concentrations in plasma from both CAP and SWP subjects were lower than healthy controls, but not significantly different between male and female sepsis patients, before and after the occurrence or the resolution of sepsis. In addition, plasma TN was not associated with the occurrence of septic shock or sepsis mortality in both genders. On the other hand, plasma TN negatively correlated with liver injury indicators in moribund SWP subjects. In mice of polymicrobial sepsis, a significant decrease in plasma TN occurred within hours after the ligation and puncture of the cecum. Recombinant human TN induced significant reductions of tissue injury markers of liver, but not other organs. In addition, exogenous TN selectively reduced the level of receptor-interacting protein kinase 3 among a panel of cell death markers in septic mouse liver. Conclusions: The dramatic and persistent down-regulation of plasma TN is not a sepsis-specific host response, but contributes to liver injury in pneumonia-associated sepsis.
„What about the others – differential diagnosis of COVID-19 in a German emergency department“
Authors: Fistera David , Haertl Annalena , Pabst Dirk , Manegold Randi , Holzner Carola , Taube Christian , Dolff Sebastian , Schaarschmidt Benedikt Michael , Umutlu Lale , Kill Clemens , Risse Joachim
Published: October 2020

Background: The ongoing COVID-19 pandemia is a major challenge for worldwide health care systems. Especially an early and safe triage in the emergency department (ED) is crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases thus differential diagnosis remains challenging.Method: We performed a retrospective study of 314 ED patients presenting with possible symptoms of COVID-19. All were tested for COVID-19 with SARS-Cov2-nasopharyngeal swab. 47 patients were positive for COVID-19. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms and vital signs. Results: Among the 267 COVID-19 negative patients 42.7% had respiratory, 14.2% other infectious and 11.2% cardiovascular diseases, followed by 9.0% oncological and 6.7% gastroenterological diagnosis. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea but more dysgeusia. Their hospital stay was significantly longer and their mortality significantly higher. Conclusion: For many common ED diagnoses COVID-19 should be considered as a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.
Bird’s-eye View of Covid-19 Emergency Preparedness Among Emergency Physicians in the Kingdom of Bahrain
Authors: Alghanem Salah , Alqassim Ghada , Zeyad Feras Abu , Isa Ruqaya , Falamarzi Horeya
Published: October 2020

Background: Coronavirus 2019 (COVID-19) has exemplified the crucial role played by emergency physicians on the frontlines, by triaging, quarantining and treating myriad patients in time. Despite this, there exists a dearth of literature comprehensively assessing the knowledge and awareness of these healthcare workers on the disease in the Kingdom of Bahrain. Objectives: This study was designed to evaluate the knowledge, attitude, and practice (KAP) of emergency physicians in the Kingdom of Bahrain towards COVID-19. Methods: This cross-sectional descriptive study included 142 emergency physicians of three major hospitals in Bahrain. A self-designed questionnaire divided into 4 parts which comprised of demographics, knowledge, attitude and practices towards COVID-19 were completed by the emergency physicians working in these hospitals. Analysis of variance (ANOVA), t-test, Chi-square test, and multiple linear regression were employed to evaluate KAP scores. Results: The mean COVID-19 knowledge and practice score was 26.29 for a maximum score of 32 suggesting an overall 82.15% correct rate on the knowledge and practice test. Multiple linear regression analysis highlighted age (p=0.038), genders (p=0.033), marital status (p=0.021), organization (p=0.032), having children (p=0.008), and continuing professional development (CPD) activity (p=0.0001) as significant predictors for knowledge and practice scores. The attitude towards the final success in controlling COVID-19 significantly differed across marital status (p=0.021), organization of participants (p=0.020) and position of participants (p=0.012) respectively.Conclusion: Good knowledge, positive attitude and sufficient safe practice towards COVID-19 were observed in majority of the participants. These findings can foster development of nuanced and salient health management strategies that augment KAP so that proper control and elimination of the disease can be achieved, while prioritizing patient health and satisfaction.
Genotype and Clinical Phenotype Analysis of a Family of Kennedy Disease
Authors: benchi CAI , SUI Zhiyan , Chen Tao
Published: October 2020

Objective: By analyzing the clinical phenotype, genotype and family characteristics of a Kennedy disease family, to explore the clinical and genetic characteristics of the family, and to further improve the understanding of the disease. And through the analysis of genotype and clinical phenotype to draw a pedigree diagram, provide genetic counseling, in order to block the continued inheritance of disease-causing genes. Methods: The research subjects were from a family of Kennedy disease discovered in January 2019. For 5 clinically diagnosed patients including the proband, the Kennedy's disease function rating scale (KD1234) and the spinal cord and bulbar muscular atrophy rating scale (SBMAFRS) were used to assess their condition, and their clinical phenotypes, laboratory tests, and neurological Analysis of electrophysiological results. After the patient's informed consent was obtained, 5ml of venous blood was drawn from the 3 members of the proband, and the CAG repeat sequence of the first exon of the androgen receptor (AR) gene was checked by polymerase chain reaction (PCR), and genetic testing was performed. analysis. Results: 1) Clinical features: The average age of onset of 5 clinical diagnosis members was (30.8±2.85) years, and the average course of disease was (12.3±4.93) years at the age of onset to milestones. This family has gynecomastia as the first symptom, and it is the most significant clinical feature. The lesions mainly involve the medulla oblongata and spinal cord. The testosterone level of 5 cases was in the normal range, and the progesterone was increased. 3 cases of estradiol were slightly elevated. The serum creatine kinase (CK) was significantly increased in 5 cases. Electromyography showed chronic extensive neurogenic damage, abnormal sensory and motor conduction. 2) The results of genetic testing showed that the 3 clinically diagnosed cases underwent genetic testing for 48 CAG repetitions (≥35 times are abnormal), and genetic diagnosis was confirmed, indicating stable inheritance.Conclusion: 1) Gynecomastia is the first symptom of the family. Androgen resistance symptoms are the outstanding clinical manifestations of this family, in addition to gynecomastia, including testicular atrophy, infertility, sexual dysfunction, etc.; 2) Changes in serum creatine kinase may indicate the progress or relief of symptoms; 3) This family There is chronic extensive neurogenic damage, prominent with sensory nerve involvement; 4) Rehabilitation training may delay the progression of muscle wasting symptoms; 5) There is a stable inheritance of CAG repeats in this family; 6) Genetic testing can diagnose the disease , The genotype is consistent with the clinical phenotype; 7) The pedigree diagram drawn according to the clinical phenotype and genotype can be used as an important basis for genetic counseling.
Effectiveness and Safety of Mepolizumab in Combination with Corticosteroids in Patients with Eosinophilic Granulomatosis with Polyangiitis
Authors: Ueno Masanobu , Miyagawa Ippei , Nakano Kazuhisa , Iwata Shigeru , Hanami Kentaro , Fukuyo Shunsuke , Kubo Satoshi , Miyazaki Yusuke , Kawabe Akio , Yoshinari Hiroko , Nakayamada Shingo , Tanaka Yoshiya
Published: October 2020

Objectives: Mepolizumab (MPZ), an anti-interleukin-5 antibody, is effective for treating eosinophilic granulomatosis with polyangiitis (EGPA). However, its effectiveness has not been adequately evaluated in real-world clinical practice. In this study, we assessed the effectiveness and safety of 300 mg MPZ for relapsing/refractory EGPA resistant to corticosteroids (CS) for 1 year in real-world settings. Methods: We administered MPZ (300 mg) to 16 patients with relapsing/refractory EGPA resistant to CS (with-MPZ). We also retrospectively collected data from the same patients for 12 months before administering MPZ (without-MPZ). The primary endpoint was the 12-month remission rate after MPZ administration, and the secondary endpoints were the Birmingham vasculitis activity score (BVAS), vasculitis damage index (VDI), eosinophil count, changes in concomitant CS doses/concomitant immunosuppressant use, MPZ retention rate, and incidence of adverse events. The clinical course was compared between Without-MPZ and With MPZ.Results: The 12-month remission rate after initiating MPZ was 75%. No change was observed in BVAS, eosinophil count, or concomitant CS dose in the without-MPZ, whereas all these parameters were significantly decreased in the with-MPZ. The number of patients on concomitant immunosuppressants also decreased in the with-MPZ. VDI did not increase in both groups. The MPZ retention rate was 100%, and only three patients (18.8%) had infections.Conclusion: This study demonstrated that MPZ is effective and safe for EGPA, furthermore, compared to Without-MPZ, MPZ improves disease activity and possesses a higher remission rate and CS sparing effect.
Identification of Covid-19 suspect cases through a digital triage: a multicenter Italian-Iranian study on
Authors: Abbadessa Gianmarco , Sparaco Maddalena , Ghajarzadeh Mahsa , Cavalla Paola , Signoriello Elisabetta , Valentino Paola , Borriello Giovanna , Clerico Marinella , Lanzillo Roberta , Lavorgna Luigi , Martino Antonio De , Mirmosayyeb Omid , Shaygannejad Vahid , Fratta Mario , Lus Giacomo , Bonavita Simona
Published: October 2020

Objective: To explore, through a digital triage monitoring, the frequency of demographic and clinical characteristics suggestive for COVID-19 among two large samples of people with Multiple Sclerosis (pwMS) and to evaluate the association between demographic and clinical characteristics of pwMS and the likelihood of being identified as COVID-19 suspect. Methods: A Google Forms triage was e-mailed to 3500 pwMS. pwMS suspects for having COVID-19 were: A) patients who reported recent contact with a patient with suspicion or diagnosis of COVID-19 and the presence of at least one symptom suggestive of COVID-19; B) pwMS with at least two symptoms suggestive of COVID-19. Demographics, clinical characteristics, and DMT categories of COVID-19-suspect vs non-suspect pwMS were compared.Results: 1035/1500 questionnaires were fulfilled by Italian pwMS and 1346/2000 by Iranian patients. 4.9% of Iranian and 1,5% of Italian pwMS met our criteria for the COVID-19-suspect case. Only diabetes and heart disease (OR: 5,374, 95%CI: 2,470 – 11,985, p-value<0.001) were independently associated with the likelihood of being suspect for COVID-19.Conclusion: The results of a digital triage system applied to a large Italian-Iranian population of pwMS to identify suspect cases of COVID-19 were discussed. Demographic and clinical characteristics of pwMS suspect for COVID-19 and the factors influencing the likelihood of being COVID-19 suspect are comparable to those of previous studies. Therefore, we encourage the use of the digital triage in patients with this chronic and severely disabling disease to pinpoint suspect case of COVID-19 in order to promptly activate the second phase of the intervention.
Optimizing the Design of a Contraceptive Microarray Patch: A Discrete Choice Experiment on Women’s Preferences in India and Nigeria
Authors: Callahan Rebecca L. , Brunie Aurélie , Lebrun Victoria , Chen Mario , Godwin Christine L. , Lakhwani Kanchan , OlaOlorun Funmilola M.
Published: October 2020

Background: Efforts are underway to develop an easy-to-use contraceptive microarray patch (MAP) that could expand the range of self-administrable methods. This paper presents results from a discrete choice experiment (DCE) designed to support optimal product design.Methods: We conducted a DCE survey of users and non-users of contraception in New Delhi, India (496 women) and Ibadan, Nigeria (two versions with 530 and 416 women, respectively) to assess stated preferences for up to six potential product attributes: effect on menstruation, duration of effectiveness, application pain, location, rash after application, and patch size. We estimated Hierarchical Bayes coefficients (utilities) for each attribute level and ran simulations comparing women’s preferences for hypothetical MAPs with varying attribute combinations.Results: The most important attributes of the MAP were potential for menstrual side effects (55% of preferences in India and 42% in Nigeria) and duration (13% of preferences in India and 24% in Nigeria). Women preferred a regular period over an irregular or no period, and a six-month duration to three or one month. Simulations show that the most ideal design would be a small patch, providing 6 months of protection, that would involve no pain on administration, result in a one-day rash, and be applied to the foot. Conclusions: To the extent possible, MAP developers should consider method designs and formulations that limit menstrual side effects and provide more than one month of protection.
Answer ALS: A Large-Scale Resource for Sporadic and Familial ALS Combining Clinical Data with Multi-Omics Data from Induced Pluripotent Cell Lines
Authors: Rothstein Jeffrey , Berry James , Svendsen Clive , Thompson Leslie , Finkbeiner Steven , Eyk Jennifer Van , Fraenkel Ernest , Cudkowicz Merit , Maragakis Nicholas , Sareen Dhruv , Norel Raquel , Dardov Victoria , Coyne Alyssa , Frank Aaron , Matlock Andrea , Pandey Rakhi , Vibhav Vineet , Lima Leandro , Wu Jie , Ramamoorthy Divya , Lim Ryan , Kaye Julia , Li Jonathan , Thompson Terri , Baxi Emily , ALS Answer
Published: October 2020

Answer ALS is a comprehensive multi-omics approach to ALS to ascertain, at a population level, the various clinical-molecular- biochemical subtypes of sporadic ALS. This national program enrolled 1046 ALS and ALS/FTD patients along with a cohort of 100 matched control patients followed longitudinally over at least one year. A smartphone-based app was employed to collect deep clinical data including fine motor activity, speech, breathing and linguistics/cognition. Analytics of the speech patterns revealed a strong correlation between clinical progression indices and speech. In parallel, blood-derived iPS motor neurons were generated from each patient and the cells underwent multi-omics analytics including whole genome sequencing, RNA transcriptomics, ATAC-Seq and proteome along with quality assurance standards. HIPPA compliant cloud data bases were employed to store all data. There are more than 6 billion clinical and molecular data points per patient generated in the program. The program was designed, and patient consented, to be open access to all clinical, biological and molecular data as well as public release of all generated iPS cell lines. A web portal is available to academics as well as commercial researchers. The ultimate intent of this data is for the generation of Integrated clinical and biological signatures using bioinformatics, statistics and computational biology to establish patterns that may lead to a better understanding of the underlying mechanisms of disease including subgroup identification. Overall, this community based clinical and science program provides for the identification of distinct reliably identifiable subgroups among the sporadic and familial patients and the great utility in iPS based approaches to disease pathophysiology and therapy discovery. Although the data is ALS centric, given the large number of both ALS and control data sets, it would also be enormously useful to others studying frontotemporal dementia, Alzheimer’s, Parkinson’s disease and others.
LY294002 Inhibit Proliferation, Migration, and Invasion of Craniopharyngiomas via PI3K/Akt Signaling Pathway
Authors: Zhou Lin , Yang Cheng Xing , Fang Lin Chun , Bao You Yuan , Wang Zhi Gang , Li Shao Yang , Li Min De , Lan Shi Hai , Wu Xiao , Tong Zhi Gao , Zheng Su Yue , Tang Bin , Hong Tao
Published: October 2020

ObjectiveCraniopharyngiomas are rare histologically benign but clinically challenging neoplasms.The aim of this study is to explore the effect and significance of PI3K signal pathway on papillary craniopharyngioma cell growth and survival.MethodsWestern blotting (WB) was used to evaluate expression of the PI3K / AKT protein in Craniopharyngiomas tissues relative to health controls. Primary tumor cells were obtained from fresh papillary craniopharyngioma samples by primary cell culture and determined by cell morphology, immunofluorescence staining and specific cell markers expression. In this study, PCPs cell lines, isolated from fresh papillary craniopharyngioma samples, were treated with different concentrations of LY294002, a specific inhibitor of the PI3K / AKT signaling pathway, in order to evaluate their proliferation, migration and invasion. The proliferation effects was determined using Cell Counting Kit-8 and colony formation. Cell apoptosis and cell cycle were detected by flow cytometry. Furthermore, cell migration and invasion levels were detected by wound healing and Transwell assays, respectively.ResultsThe expression of p-PI3K and p-AKT were obviously higher in human craniopharyngioma tissue relative to their corresponding normal control. PCPs primary cells were isolated and detected by immunofluorescence, and PCPs cytokeratin (pan CK) and vimentin protein (VIM) were detected.The inhibition of PI3K / AKT signaling pathway can significantly inhibit the proliferation, migration and invasion of PCPs primary cells.Conclusions﻿LY294002 effectively inhibits the proliferation, migration and invasion of PCPs cells through the PI3K / AKT signaling pathway.
CT and MRI Characteristic Findings of Sporadic Renal Hemangioblastoma: Two Case Reports and Review of the Literature
Authors: He Jie , Liu Nan , Liu Wangwang , Wang Qiangfeng , Zhou Wenli , Hu Hongjie
Published: October 2020

BackgroundHemangioblastoma in the kidney is rare. Although a few renal hemangioblastoma cases have been reported, the content of these articles mainly focused on clinical and pathological research, with minimal descriptions of radiologic findings. Moreover, there are no descriptions of magnetic resonance imaging with enhancement for this condition. We herein report two cases of renal hemangioblastoma with computed tomography and magnetic resonance imaging findings.Case presentationTwo patients presented to our institution due to dull pain of the left abdomen, and a mass in the left kidney was found by ultrasound examination in each case. They had no special family history. Physical examination revealed no obvious tenderness or percussion pain in the renal region and ureteral walking area, and there was no obvious mass. Routine blood and urine tests were normal, and serum tumor markers were negative. No obvious lesions were found on imaging of other body parts. Similar radiologic findings were observed in both cases and mimicked those of cavernous hemangiomas of the liver, including peripheral nodular enhancement in the corticomedullary phase, progressive centripetal enhancement in the nephrographic and delayed phases, and occasional complete “filling in” in the delayed phase. Given the suspicion for renal cell carcinoma, both patients underwent partial nephrectomy. The pathological results showed renal hemangioblastoma.ConclusionsRenal hemangioblastoma is a rare benign tumor that is easily misdiagnosed as clear cell carcinoma. Characteristic computed tomography and magnetic resonance imaging manifestations may improve preoperative diagnostic accuracy to avoid surgery or indicate nephron-sparing surgery.
Less Experienced but Healthier: Health Behaviors of Medical Students Compared With Practicing Physicians
Authors: Miron Rachel Wilf , Kagan Ilya , Saban Mor
Published: October 2020

BackgroundWe examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians. MethodsThis cross–sectional study was performed among second-year medical students (2015-2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed. ResultsSignificantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress. ConclusionsThe healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them gain more years of healthy life, allowing students and physicians to be better role models and the healthcare system to perform better.
An artificial intelligence nanopore platform for SARS-CoV-2 virus detection
Authors: Taniguchi Masateru , Minami Shohei , Ono Chikako , Hamajima Rina , Morimura Ayumi , Hamaguchi Shigeto , Akeda Yukihiro , Kanai Yuta , Kobayashi Takeshi , Kamitani Wataru , Terada Yutaka , Suzuki Koichiro , Hatori Nobuaki , Yamagishi Yoshiaki , Washizu Nobuei , Takei Hiroyasu , Sakamoto Osamu , Naono Norihiko , Tatematsu Kenji , Washio Takashi , Matsuura Yoshiharu , Tomono Kazunori
Published: October 2020

High-throughput, high-accuracy detection of emerging viruses allows for pandemic prevention and control. Currently, reverse transcription-polymerase chain reaction (RT-PCR) is used to diagnose the presence of SARS-CoV-2. The principle of the test is to detect RNA in the virus using a pair of primers that specifically binds to the base sequence of the viral RNA. However, RT-PCR is a sophisticated technique requiring a time-consuming pretreatment procedure for extracting viral RNA from clinical specimens and to obtain high sensitivity. Here, we report a method for detecting novel coronaviruses with high sensitivity using artificial intelligent nanopores utilizing a simple procedure that does not require RNA extraction. Artificial intelligent nanopore platform consists of machine learning software on the servers, portable high-speed and high-precision current measuring instrument, and scalable, cost-effective semiconducting nanopore modules. Here we show that the artificial intelligent nanopores are successful in accurate identification of four types of coronaviruses, HCoV-229E, SARS-CoV, MERS-CoV, and SARS-CoV-2, which are usually extremely difficult to detect. The positive/negative diagnostics of the new coronavirus is achieved with a sensitivity of 95 % and specificity of 92 % with a 5-minute diagnosis. The platform enables high throughput diagnostics with low false negatives for the novel coronavirus.
Treatment of Diaphyseal Forearm Defects Caused by Infection Using Ilizarov Segmental Bone Transport Technique
Authors: Liu Yanshi , Yushan Maimaiaili , Liu Zhenhui , Liu Jialin , Ma Chuang , Yusufu Aihemaitijiang
Published: October 2020

Background The Ilizarov segmental bone transport technique can be applied in the reconstruction of the bone defects with less invasive fashion and more versatility compared to other methods, while most studies were focused on the lower extremity. The purpose of this study was to evaluate the effectiveness of the Ilizarov segmental bone transport technique in the treatment of diaphyseal forearm bone defects caused by infection.Methods: This study included 12 patients with diaphyseal forearm bone defects caused by infection, who underwent bone transport procedures using the monolateral external fixator at our institution from January 2010 to January 2018, including 10 males and 2 females with a mean age of 39 years (range 23-57 years). Patient’s demographic data and clinical outcomes at least two years follow-up after removing the external fixator were collected and retrospectively analyzed. The functional results were evaluated by the questionnaire of Disability of Arm, Shoulder and Hand (DASH) and the modified Mayo wrist score (MWS) at the final follow-up.Results: There were 10 radii and 2 ulnae bone transport procedures collected. The average defect size was 5.1 cm (4-6.5 cm). All patients were successfully followed up with a mean period of 28.2 months (24 to 36 months) and achieved infection-free union. There was no recurrence of infection observed. The mean external fixation time was 232.6 days (182 to 276 days), and the mean external fixation index was 46.3 days/cm (40.9 to 61.8 days/cm). The mean DASH score was 30.6(18 to 49) preoperative, while 13.8 (5 to 26) at the final follow-up. The average modified MWS improved from 68.8 (55 to 80) pre-operatively to 83.8 (65 to 90) at the final follow-up. All the differences between the preoperative and final scores were statistically significant (p<0.05). Almost all the patients achieved satisfactory clinical outcomes and were able to perform activities of daily living. Conclusion: Ilizarov segmental bone transport technique is an alternative and effective method for the treatment of diaphyseal forearm bone defects caused by infection, and this method acquired satisfactory clinical outcomes.
Complications of Posttraumatic Dorsal Cervical Spine Fusion
Authors: Kasapovic Adnan , Welle Kristian , Hackenberg Roslind , Schwetje Desirée , Rommelspacher Charlotte , Kabir Koroush
Published: October 2020

Background: This study evaluates the occurence of complications of dorsal cervical spine fusion after cervical spine injuries. Methods:Dorsal cervical spine fusion due to fractures of the cervical spine was performed in 40 patients. During the first 6 postoperative weeks the occurrence of complications was observed.Results:In most cases the dorsal fusion was performed in the upper cervical spine. Severe systemic diseases were common in the cohort. No intraoperative complications, implant malpositioning or postoperative neurologic deficits were observed. In 3 cases a revision operation was performed due to surgical site infection. General complications were common (19 cases = 47.5 %) with pneumonia (20%) and cardial complications (12.5%) as the most frequent complications. In 2 cases (5%) the complications led to death due to sepsis and cardiogenic shock. Conclusions: Following the findings of our study there is a low surgical revision and complication rate after dorsal cervical spine fusion, while the rate of general complications appears to be much higher. Taking these complications into account cervical fusion operations should carefully be taken into consideration as a therapy option in cervical spine fractures. Trial registration: All procedures performed in the present study were in accordance with the ethical standards approved by the Ethical Committee of University Hospital Bonn, Bonn, Germany (reference number: 406/17)
Does Dynamic Ventral Plate Fixation Provide Adequate Stability for Traumatic Subaxial Cervical Spine Fractures in Mid-term Follow-up?
Authors: Lang Siegmund , Neumann Carsten , Fiedler Lasse , Alt Volker , Loibl Markus , Kerschbaum Maximilian
Published: October 2020

BackgroundIt remains questionable if the treatment of cervical fractures with dynamic plates in trauma surgery provides adequate stability for fractures with disco-ligamentous injuries. The primary goal of this study was to assess the radiological and mid-term patient-reported outcome of traumatic subaxial cervical fractures treated with a dynamic plate compared to rigid locking plate system.Patients and MethodsPatients, treated with anterior cervical discectomy and fusion (ACDF) between 2001 and 2015, using either a dynamic plate (DP: Mambo™, Ulrich, Germany) or a rigid locking plate (RP: CSLP™, Depuy Synthes, USA), were identified. Only patients with complete radiological follow (pre- and postoperatively and minimum one year after surgery) were included in the study. Next to the sagittal alignment, the sagittal anterior translation and the bony consolidation were evaluated. After at least two years the patient reported outcome measures (PROM) were evaluated using the German Short-Form 36 (SF-36) with the physical components summary (PCS) and mental components summary (MCS), Neck Disability Index (NDI) and the EuroQol in 5 Dimensions (EQ-5D) score.Results33 patients met the in- and exclusion criteria. 26 patients suffered from an AO Type B or C fracture. 13 patients were treated with a dynamic plate and 20 with a rigid locking plate. Both, the sagittal alignment, and the sagittal translation could be sufficiently restored with no differences between the two groups (p ≥ 0.05). No significant loss of reduction could be observed at the follow-up in both groups (p ≥ 0.05). Bony consolidation could be observed in 30 patients (91%) with no significant differences between both groups (DP: 12/13 (92%); RP: 18/20 (90%); (p ≥ 0.05)). In 20 patients PROMs could be evaluated after a mean follow-up of 71.2±25.5 months. No significant differences between DP and RP could be detected in EQ-5D, SF- 36 (PCS and MCS) or NDI (EQ-5D: 72±5; SF-36 PCS 41.9±16.2, MCS 45.4±14.9; NDI: 11±9).ConclusionThe dynamic plate concept provides enough stability without a difference in fusion rates in comparison to rigid locking plates in a population that mostly suffered AO Type B and C fractures.
The Person I Used To Be: Employment Experiences of Young Adults with Cancer
Authors: Scardaville Melissa C. , Murphy Kathleen M. , Clayman Marla , Robert Rhonda , Medina-George Sandra , Nguyen Vinh , Frieden Lex
Published: October 2020

Purpose: Adults can experience employment-related hardships after a cancer diagnosis but young adults at the beginning of their careers may face unique challenges. This study explored the impact of cancer on young adults’ employment experiences. Methods: The authors conducted 27 qualitative semi-structured interviews with young adults who had received a cancer diagnosis. Results: Participants encountered mixed workplace support. Many reported that they did not have the benefits, such as time off or short-term disability insurance, that would have ameliorated some challenges encountered during treatment. They also shared that many workplaces do not do an adequate job of informing people with cancer about federal laws that protect people with disabilities. Most participants reported that the cancer diagnosis and treatment caused them to rethink their career trajectory.Conclusions: Cancer affects young adults in ways that present distinct struggles attributable to less access to resources. Career choices and the consequent opportunities for on-the-job training can have lifelong import.Implications for Cancer Survivors: Disability and discrimination laws do not protect all employees. Young adult cancer survivors may need to conduct their own research into these protections so they can receive entitled benefits. They and employers may also benefit from workplace interventions or trainings to lessen the employment consequences of cancer.