bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of cinnamaldehyde on anti-respiratory syncytial virus
Authors: Feng Lan , Li Jing , Yu Hai-Bo , Xue Qing , Dai Li-Juan
Published: May 2020

Background:

Previous reports found that cinnamaldehyde has effects on anti-respiratory syncytial virus (ARSV). However, their results are still contradictory. Therefore, this study will systematically address the effects of cinnamaldehyde on ARSV.

Methods:

The following electronic bibliographic databases will be retrieved from their outset to the March 31, 2020: MEDLINE, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Technology Periodical Database, China Biology Medicine, and China National Knowledge Infrastructure. No language and publication time limitations will be exerted in this study. All relevant case-controlled studies or randomized controlled studies exploring the effects of cinnamaldehyde on ARSV will be included. Study quality of case-controlled studies will be assessed by Newcastle–Ottawa scale, and that of randomized controlled studies will be identified by Cochrane risk of bias tool. All data pooling and analysis will be performed using RevMan 5.3 software.

Results:

This study will summarize the up-to-date high-quality evidence to synthesize outcome data on the effects of cinnamaldehyde on ARSV.

Conclusion:

Findings of this study may provide beneficial evidence for both clinicians and future studies regarding the effects of cinnamaldehyde on ARSV.

Systematic review registration:

INPLASY202040074.
Increased risk of gallstones after appendectomy
Authors: Kim So Young , Lim Hyoseob , Park Bumjung , Lim Hyun , Kim Miyoung , Kong Il Gyu , Choi Hyo Geun
Published: May 2020

To evaluate the association between appendectomy and the occurrence of gallstones using a national sample cohort from Korea.

The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. We extracted data for patients who had undergone appendectomy (n = 14,955) and a 1:4 matched control group (n = 59,820) and then analyzed the occurrence of gallstones. The patients were matched according to age, sex, income, region of residence, hypertension, diabetes mellitus, and history of dyslipidemia. Appendectomies were identified using operation codes (Q2860-Q2863) for appendicitis alone (International Classification of Disease-10: K35). Gallstones were diagnosed if the corresponding International Classification of Disease-10 code (K80) was reported ≥2 times. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using stratified Cox proportional hazard models, and 95% confidence intervals were calculated. Subgroup analyses were performed based on age, sex, and time period after appendectomy.

The adjusted HR for gallstones was 1.78 (95% confidence interval = 1.51–2.09, P < .001) in the appendectomy group. Consistent HRs were found in the analyses of all the subgroups determined using age and sex, with the exception of men ≥60 years of age. The risk of gallstones was increased during the first year after appendectomy.

The occurrence of gallstones was increased in the patients who had undergone appendectomy.
Use of intrapulmonary administration of thrombin in hematological malignancy patients with alveolar haemorrhage
Authors: Lee Jongmin , Rhee Chin Kook , Kim Seok Chan , Kim Young Kyoon , Kim Hee Je , Lee Seok , Cho Seok-Goo , Lee Jong Wook
Published: May 2020

Introduction:

Alveolar hemorrhage (AH) is characterized by the acute onset of alveolar bleeding and hypoxemia and can be fatal. Thrombin has been widely used to achieve coagulation and hemostasis. However, the efficacy of thrombin in patients with AH is unclear. Thus, this study aimed to evaluate the efficacy of thrombin administration in patients with hematological malignancy and AH.

Patient concerns and diagnoses:

This retrospective study included 15 hematological malignancy patients (8 men and 7 women; mean age 47.7 ± 17.3 years) with AH who were administered intrapulmonary thrombin between March 2013 and July 2018.

Interventions and outcomes:

All patients received bovine-origin thrombin (1000 IU/ml, Reyon Pharmaceutical Co., Ltd., Seoul, Korea) via a fiberoptic bronchoscope. A maximum of 15 ml of thrombin was injected via the working channel to control bleeding. The ability of thrombin to control bleeding was assessed. Additionally, the change in the PaO2/FiO2 (PF) ratio after intrapulmonary thrombin administration was evaluated. Intrapulmonary thrombin was administered a minimum of 3 days after starting mechanical ventilation in all patients, and it immediately controlled the active bleeding in 13 of 15 patients (86.7%). However, AH relapse was noted in 3 of the 13 patients (23.1%). The PF ratio improved in 10 of 15 patients (66.6%), and the mean PF ratio was significantly higher after thrombin administration than before administration (P = .03). No adverse thromboembolic complications or systemic adverse events were observed.

Conclusion:

Thrombin administration was effective in controlling bleeding in hematological malignancy patients with AH. Intrapulmonary thrombin administration might be a good therapeutic option for treating AH.
Experiences and perceptions risk of health-care workers from coronavirus
Authors: Chen Peng , Lei Jiexin , Chen Fuchao , Zhou Benhong
Published: May 2020

Background:

Healthcare workers (HCWs) were at the frontline during the battle against coronavirus. Understanding and managing their fears and anxieties may hold lessons for handling future outbreaks. However, the experiences and perceptions risk of HCWs from coronavirus still remains to be controversial. Thus, the objective of this review is to identify, appraise, and synthesize available evidence related to the experiences and perceptions of risk of HCWs from coronavirus.

Methods:

The studies were gathered from PubMed, Cochrane Library, EMBASE, CBMdisc, CNKI, WKSP, CSJFT, Google Scholar, and PsycINFO, along with several sources of gray literature. The retrieval of full-text studies, data extraction, and quality assessment of the included studies will be independently conducted by 2 reviewers. The meta-aggregative will be used for findings pooling and a summary of ConQual findings tables will be presented in future.

Results:

This study will be submitted to a peer-reviewed journal for publication.

Conclusion:

The literature will provide a high-quality analysis of the current evidence to assess the experiences and perceptions risk of health-care workers from coronavirus.

Registration information:

CRD42020170388.
Hypomethylation of the cyclin D1 promoter in hepatitis B virus-associated hepatocellular carcinoma
Authors: Liu Hui-Hui , Fang Yu , Wang Jing-Wen , Yuan Xiao-Dong , Fan Yu-Chen , Gao Shuai , Han Li-Yan , Wang Kai
Published: May 2020

The hypomethylation of the Cyclin D1 (CCND1) promoter induced by excess oxidative stress likely promotes the development of hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC). We aimed to evaluate methylation status of the CCND1 promoter as a new plasma marker for the detection of HBV-HCC.

We consecutively recruited 191 participants, including 105 patients with HBV-HCC, 54 patients with chronic hepatitis B (CHB), and 32 healthy controls (HCs). Using methylation-specific polymerase chain reaction, we identified the methylation status of the CCND1 promoter in plasma samples. We analyzed the expression levels of the CCND1 mRNA in peripheral blood mononuclear cells by using quantitative real-time PCR. We assessed the plasma levels of superoxide dismutase, 8-hydroxydeoxyguanosine and malondialdehyde by using enzyme-linked immunosorbent assays.

Patients with HBV-HCC (23.81%) presented a reduced methylation frequency compared with patients with CHB (64.81%) or HCs (78.13%) (P < .001). When receiver operating characteristic curves were plotted for patients with HBV-HCC versus CHB, the methylation status of the CCND1 promoter yielded diagnostic parameter values for the area under the curve of 0.705, sensitivity of 76.19%, and specificity of 64.81%, thus outperforming serum alpha-fetoprotein (AFP), which had an area under the curve of 0.531, sensitivity of 36.19%, and specificity of 90.74%. Methylation of the CCND1 promoter represents a prospective diagnostic marker for patients with AFP-negative HBV-HCC and AFP-positive CHB. The expression levels of CCND1 mRNA was increased in patients with HBV-HCC compared with patients with CHB (Z = -4.946, P < .001) and HCs (Z = -6.819, P < .001). Both the extent of oxidative injury and antioxidant capacity indicated by the superoxide dismutase, 8-hydroxydeoxyguanosine and malondialdehyde levels were increased in patients with HBV-HCC. Clinical follow up of patients with HBV-HCC revealed a worse overall survival (P = .012, log-rank test) and a decreased progression-free survival (HR = 0.109, 95%CI: 0.031-0.384) for the unmethylated CCND1 group than methylated CCND1 group.

Our study confirms that oxidative stress appears to correlate with plasma levels of CCND1 promoter methylation, and the methylation status of the CCND1 promoter represents a prospective biomarker with better diagnostic performance than serum AFP levels.
Cupping for psoriasis vulgaris
Authors: Zhang Jie , Yu Qianying , Peng Li , Zhang Feng , Lin Wenxia , Guo Jing , Xiao Min , Chen Mingling
Published: May 2020

Background:

Psoriasis vulgaris (PV) is a chronic, immune-mediated dermatological disease that significantly affects the patient's health and quality of life. At present, cupping has been widely used in the treatment of psoriasis. However, the effectiveness and safety of cupping in patients with PV are still controversial. Therefore, this review aims to evaluate the efficacy and safety of cupping therapy on PV.

Methods:

The following databases will be searched from their inceptions to April 2020 with a language limitation of English and Chinese: Pubmed, Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Databas, China National Knowledge Infrastructure Database, Wanfang database and Chinese Scientific Journal Database. The reference lists of eligible studies and other resources will also be searched. Two researchers will independently perform the selection of studies, data extraction, and data analysis. A fixed or random-effect model will be applied to synthesize data depend on the heterogeneity test. The primary outcome is the proportion of patients achieving at least a 60% improvement in psoriasis area and severity index (PASI) score from baseline (PASI 60). Secondary outcomes include the proportion of patients achieving at least a 90% improvement in PASI score from baseline (PASI 90), the mean change of PASI and dermatology life quality index score, the itching index, adverse events, and recurrence rate. RevMan V.5.3 software will be used for meta-analysis.

Results:

The study will provide a high-quality evidence-based review of cupping for PV.

Conclusions:

The study will be conducted to evaluate the efficacy and safety of cupping in the treatment of PV and supposed to provide clear evidence for the clinical application of cupping therapy.

Ethics and dissemination:

As the study is a protocol of systematic review and meta-analysis that does not involve individual data, ethical approval will not be required. The results will be published in a peer-reviewed journal.

OSF Registration number:

DOI 10.17605/OSF.IO/KV4CJ
Single-cell fate decisions of bipotential hematopoietic progenitors
Authors: Brand Marjorie , Morrissey Edward
Published: May 2020

Purpose of review

In hematopoiesis, rapid cell fate decisions are necessary for timely responses to environmental stimuli resulting in the production of diverse types of blood cells. Early studies have led to a hierarchical, tree-like view of hematopoiesis with hematopoietic stem cells residing at the apex and serially branching out to give rise to bipotential progenitors with increasingly restricted lineage potential. Recent single-cell studies have challenged some aspects of the classical model of hematopoiesis. Here, we review the latest articles on cell fate decision in hematopoietic progenitors, highlighting single-cell studies that have questioned previously established concepts and those that have reaffirmed them.

Recent findings

The hierarchical organization of hematopoiesis and the importance of transcription factors have been largely validated at the single-cell level. In contrast, single-cell studies have shown that lineage commitment is progressive rather than switch-like as originally proposed. Furthermore, the reconstruction of cell fate paths suggested the existence of a gradient of hematopoietic progenitors that are in a continuum of changing fate probabilities rather than in a static bipotential state, leading us to reconsider the notion of bipotential progenitors.

Single-cell transcriptomic and proteomic studies have transformed our view of lineage commitment and offer a drastically different perspective on hematopoiesis.
Neurostimulation in neurogenic patients
Authors: Martens F.M.J. , Sievert K-D.
Published: May 2020

Purpose of review

To provide an overview of available electrical stimulation devices in neurogenic patients with lower urinary tract disease.

Recent findings

It is advocated to do more studies in neurogenic patients as results seem promising and useful but most studies did not include neurogenic patients or neurogenic patients were not analyzed or reported separately. Most studies included a small heterogenous neurogenic group with multiple pathophysiologic origin focusing on effect of a treatment instead of results of a treatment in a specific neurogenic group. Neuromodulation or stimulation has the advantage that it acts on different organs, like bladder and bowel, so can treat neurogenic patients, who mostly suffer from multiple organ failure.

Brindley procedure, sacral neuromodulation (SNM) and posterior tibial nerve stimulation (PTNS) are available for a while already. The Brindley procedure (including sacral anterior root stimulation in combination with a rhizotomy of posterior sacral roots) is developed for selected spinal cord injury patient with a complete spinal injury, and has shown results for many years in neurogenic patients. An alternative to the rhizotomy is not established yet. SNM and PTNS are other modalities that are used in nonneurogenic patients, but are not yet indicated and much studied in neurogenic patients.
Lung Function Predicts Outcome in Children With Obstructive Lung Disease After Hematopoietic Stem Cell Transplantation
Authors: Kim Kyunghoon , Lee Hye Jin , Kim Seongkoo , Lee Jae Wook , Yoon Jong-Seo , Chung Nack Gyun , Cho Bin
Published: May 2020

Obstructive lung disease (OLD) that develops after hematopoietic stem cell transplantation (HSCT) has a significant impact on morbidity and mortality. We investigated the role of pulmonary function tests (PFTs) in the prediction of prognosis of OLD in children who have undergone HSCT. We retrospectively reviewed 538 patients who underwent allogenic HSCT in the Department of Pediatrics, Seoul St. Mary’s Hospital, South Korea, from April 2009 to July 2017. OLD was identified on PFTs or chest computed tomography scans obtained from 3 months after HSCT onwards. OLD developed after HSCT in 46 patients (28 male individuals, median age: 11.2 y). The group that developed OLD with an unfavorable prognosis (n=23) had a lower forced vital capacity (FVC) (% of predicted, 78.53±24.00 vs. 97.71±16.96, P=0.01), forced expiratory volume in 1 second (FEV1) (% of predicted, 52.54±31.77 vs. 84.44±18.59, P=0.00), FEV1/FVC (%, 59.28±18.68 vs. 79.94±9.77, P=0.00), and forced expiratory flow at 25% to 75% of forced vital capacity (FEF25-75) (% of predicted, 30.95±39.92 vs. 57.82±25.71, P=0.00) at diagnosis than the group that developed OLD with a favorable prognosis (n=23). The group that developed OLD with an unfavorable prognosis had significant reductions in FVC, FEV1, FEV1/FVC, and FEF25-75 at 2 years after diagnosis. Children who develop OLD with an unfavorable prognosis after HSCT already have poor lung function at the time of diagnosis. Additional treatment should be considered in patients who develop OLD after HSCT according to their PFTs at diagnosis.
Occurrence and Risk Factors for Unplanned Catheter Removal in a PICU: Central Venous Catheters Versus Peripherally Inserted Central Venous Catheters
Authors: Shimizu Yoshiyuki , Hatachi Takeshi , Takeshita Jun , Inata Yu , Kyogoku Miyako , Aoki Yoshihiro , Taniguchi Masashi , Kawamura Atsushi , Okumura Jumpei , Takeuchi Muneyuki
Published: May 2020

Objectives:

We aimed to identify the occurrence and risk factors for unplanned catheter removal due to catheter-associated complications and the effects on catheter survival probability in a PICU.

Design:

Retrospective, single-center, observational study of cases involving conventional central venous catheters or peripherally inserted central venous catheters.

Setting:

The PICU of a tertiary children’s hospital.

Patients:

Consecutive PICU patients with central venous catheters between April 2016 and February 2019.

Interventions:

None.

Measurements and Main Results:

We identified unplanned catheter removals that were related to central line-associated bloodstream infection, thrombosis, and mechanical complications. During the study period, 582 central venous catheters and 474 peripherally inserted central venous catheters were identified. The median durations of catheter placement were 4.0 days for central venous catheters and 13.0 days for peripherally inserted central venous catheters (p < 0.001), and unplanned catheter removals due to catheter-associated complications were in 52 (8.9%) central venous catheter cases and 132 (27.8%) peripherally inserted central venous catheter cases (p < 0.001) (15.0 and 16.0 per 1,000 catheter-days, respectively [p = 0.75]). Unplanned catheter removal was associated with a peripheral catheter tip position among both central venous catheters and peripherally inserted central venous catheters (p < 0.001 and p = 0.001), and it was associated with surgical patient status among peripherally inserted central venous catheters (p = 0.009). In contrast, the use of ultrasound-guided insertion was associated with a lower occurrence of unplanned catheter removal among peripherally inserted central venous catheters (p = 0.01). With regard to catheter survival probability, there was no significant difference between central venous catheters and peripherally inserted central venous catheters (p = 0.23). However, peripherally inserted central venous catheters had a lower occurrence of central line-associated bloodstream infection than central venous catheters (p = 0.03), whereas there was no significant difference in the rates of thrombosis (p = 0.29) and mechanical complications (p = 0.84) between central venous catheters and peripherally inserted central venous catheters.

Conclusions:

In a PICU, peripherally inserted central venous catheters had lower occurrence of central line-associated bloodstream infection than central venous catheters; however, similar catheter survival probabilities were observed between both catheters. A central catheter tip position for both catheters and ultrasound-guided insertion for peripherally inserted central venous catheters may help limit unplanned catheter removal due to catheter-associated complications.
Rehabilitation Medicine Response to the COVID-19 Pandemic
Authors: Stein Joel , Visco Christopher J. , Barbuto Scott
Published: May 2020

The COVID-19 pandemic has spread across the globe at a rapid rate, affecting large numbers of individuals in different countries with varying healthcare systems and infrastructure. In the United States, New York City has been the epicenter of the COVID-19 outbreak, and the peak impact in this region has come earlier in this location than most other parts of the country. We report our experience preparing for this pandemic in a New York City academic medical center and its regional healthcare system, the issues confronted during the rise and peak of the number of cases, and the plans for the postpeak recovery and adjustment to the new reality of providing rehabilitation in an environment where COVID-19 remains prevalent.
HIV Testing and PrEP Use in a National Probability Sample of Sexually Active Transgender People in the United States
Authors: Sevelius Jae M. , Poteat Tonia , Luhur Winston E. , Reisner Sari L. , Meyer Ilan H.
Published: May 2020

Background:

HIV testing and pre-exposure prophylaxis (PrEP) are effective HIV prevention strategies often underused by transgender people.

Methods:

Recruitment occurred in 2 phases to identify transgender respondents in a probability sample of adults in the United States. Transgender respondents completed a self-administered paper or web-based survey designed to assess transgender population health. Sexually active respondents (HIV-negative and had sex in the 5 years previously, N = 190) and a subsample of those at risk for sexual HIV acquisition (sex with cisgender men or transgender women, n = 120) were included in analyses.

Results:

Of the full sample of sexually active respondents, those who were transfeminine were less likely to be familiar with PrEP; most (72%) reported favorable attitudes toward PrEP. Of those at risk for HIV acquisition, 23% had never tested for HIV. Respondents of color were more likely than white respondents to meet Centers for Disease Control and Prevention recommendations for HIV testing. Respondents who met Centers for Disease Control and Prevention recommendations for HIV testing were more likely to report looking online for lesbian, gay, bisexual, and transgender or transgender-specific health information. Few respondents reported currently taking PrEP (3%); those who reported higher levels of nonaffirmation of their gender identity were less likely to currently use PrEP.

Discussion:

These findings may indicate some success of HIV testing outreach programs that prioritize people at higher risk for acquiring HIV, focusing on those who are vulnerable to structural marginalization. Ongoing public health efforts are needed to increase HIV testing and PrEP awareness among transgender adults, who are disproportionately impacted by HIV.
The Association Between Preoperative Opioid Exposure and Prolonged Postoperative Use
Authors: Katzman Charles , Harker Emily C. , Ahmed Rizwan , Keilin Charles A. , Vu Joceline V. , Cron David C. , Gunaseelan Vidhya , Lai Yen-Ling , Brummett Chad M. , Englesbe Michael J. , Waljee Jennifer F.
Published: May 2020

Objective:

To determine the effect of nonchronic, periodic preoperative opioid use on prolonged opioid fills after surgery.

Background:

Nonchronic, periodic opioid use is common, but its effect on prolonged postoperative opioid fills is not well understood. We hypothesize greater periodic opioid use before surgery is correlated with persistent postoperative use.

Methods:

We used a national private insurance claims database, Optum's de-identifed Clinformatics Data Mart Database, to identify adults undergoing general, gynecologic, and urologic surgical procedures between 2008 and 2015 (N = 191,043). We described patterns of opioid fills based on dose, recency, duration, and continuity to categorize preoperative opioid exposure. Patients with chronic use were excluded. Our primary outcome was persistent postoperative use, defined as filling an opioid prescription between 91- and 180-days post-discharge. The association between preoperative opioid use and persistent use was determined using multivariable logistic regression, controlling for clinical covariates.

Results:

In the year before surgery, 41% of patients had nonchronic, periodic opioid fills. Compared with other risk factors, patterns of preoperative fills were most strongly correlated with persistent postoperative opioid use. Patients with recent intermittent use were significantly more likely to have prolonged fills after surgery compared with opioid-naïve patients [minimal use: odds ratio (OR): 2.0, 95% confidence interval (CI) 1.89–2.03; remote intermittent: OR 4.7, 95% CI 4.46–4.93; recent intermittent: OR 12.2, 95% CI 11.49–12.90].

Conclusions:

Patients with nonchronic, periodic opioid use before surgery are vulnerable to persistent postoperative opioid use. Identifying opioid use before surgery is a critical opportunity to optimize care after surgery.
Surgeon Quality Control and Standardization of D2 Lymphadenectomy for Gastric Cancer
Authors: Han Sang-Uk , Hur Hoon , Lee Hyuk-Joon , Cho Gyu Seok , Kim Min-Chan , Park Young Kyu , Kim Wook , Hyung Woo Jin
Published: May 2020

Objective:

To qualify surgeons to participate in a randomized trial comparing laparoscopic and open distal D2 gastrectomy for advanced gastric cancer.

Summary of Background Data:

No studies have sought to qualify surgeons for a randomized trial comparing laparoscopic and open D2 gastrectomy for advanced gastric cancer.

Methods:

We conducted a multicenter prospective observational study evaluating unedited videos of laparoscopic and open D2 gastrectomy performed by 27 surgeons. Surgeons performed 3 of each laparoscopic and open distal gastrectomies with D2 lymphadenectomy for gastric cancer. Five peers reviewed each unedited video using a video assessment form. Based on experts’ review of videos, a separate review committee decided surgeons as “Qualified” or “Not-qualified.”

Results:

Twelve surgeons (44.4%) were qualified on initial evaluation whereas the other 15 surgeons were not. Another 9 surgeons were finally qualified after re-evaluation. The median score for Qualified was significantly higher than Not-qualified (P < 0.001).

Significant differences between Qualified and Not-qualified were noted both in operation type and in all evaluation area of surgical skill, perigastric, and extra-perigastric lymphadenectomy, although the inter-rater variability of the assessment score was low (kappa = 0.285). However, Not-qualified surgeons’ scores improved upon re-evaluation of resubmitted videos.

When compared laparoscopy with open surgery, median scores were similar between the 2 groups (P = 0.680). However, open gastrectomy scores for surgical skills were significantly higher than for laparoscopic surgery (P = 0.016).

Conclusions:

Our surgeon quality control study for gastrectomy represents a milestone in surgical standardization for surgical clinical trials. Our methods could also serve as a system for educating surgeons and assessing surgical proficiency.
Safety and Efficacy of Bariatric Surgery in Cirrhosis Patients With Extreme Obesity
Authors: Vuppalanchi Raj , McCabe Marshall E. , Tandra Sweta R. , Parcha Siva P. , Ghafoor Adil , Schuh Leslie , Inman Margaret M. , Selzer Don J. , Stefanidis Dimitrios , Chalasani Naga
Published: May 2020

Objective:

To assess the safety and efficacy of bariatric surgery in patients with cirrhosis.

Summary Background Data:

Bariatric surgery may be a viable option for patients with cirrhosis and extreme obesity. However, the risk of liver decompensation after surgery is not thoroughly investigated.

Methods:

We conducted a case-controlled study with 106 obese patients with cirrhosis (cases) and 317 age, sex, body mass index-, and type of surgery-matched obese patients without cirrhosis (controls) who underwent bariatric surgery.

Results:

Patients with cirrhosis were predominantly Child-Pugh class A (97%) with the diagnosis established prior to surgery in only 46%. In the cirrhosis group, there was no death in the first 30 days compared with 1 patient in the control group. At 90 days there was 1 death in the cirrhosis group but no additional deaths in the control group. In total, 12 months after the surgery, there were 3 deaths in the cirrhosis group and 1 in the control group (2.8% vs 0.6%, P = 0.056). The surgery-related length of stay was significantly longer in patients with cirrhosis (3.7 ± 4.0 vs 2.6 ± 2.4 d, P = 0.001), but the 30-day readmission rate was lower (7.5% vs 11.9%, P = 0.001). The percent of total weight loss at 30 and 90-days was not significantly different between the groups and remained that way even at 1 year (29.1 ± 10.9 vs 31.2 ± 9.4%, P = 0.096).

Conclusions:

Bariatric surgery in obese cirrhotic patients is not associated with excessive mortality compared with noncirrhotic obese patients.
Implementation Strategies and the Uptake of the World Health Organization Surgical Safety Checklist in Low and Middle Income Countries
Authors: White Michelle C. , Peven Kimberly , Clancy Olivia , Okonkwo Ijeoma , Bakolis Ioannis , Russ Stephanie , Leather Andrew J. M. , Sevdalis Nick
Published: May 2020

Objectives:

To identify the implementation strategies used in World Health Organization Surgical Safety Checklist (SSC) uptake in low- and middle-income countries (LMICs); examine any association of implementation strategies with implementation effectiveness; and to assess the clinical impact.

Background:

The SSC is associated with improved surgical outcomes but effective implementation strategies are poorly understood.

Methods:

We searched the Cochrane library, MEDLINE, EMBASE and PsycINFO from June 2008 to February 2019 and included primary studies on SSC use in LMICs. Coprimary objectives were identification of implementation strategies used and evaluation of associations between strategies and implementation effectiveness. To assess the clinical impact of the SSC, we estimated overall pooled relative risks for mortality and morbidity. The study was registered on PROSPERO (CRD42018100034).

Results:

We screened 1562 citations and included 47 papers. Median number of discrete implementation strategies used per study was 4 (IQR: 1–14, range 0–28). No strategies were identified in 12 studies. SSC implementation occurred with high penetration (81%, SD 20%) and fidelity (85%, SD 13%), but we did not detect an association between implementation strategies and implementation outcomes. SSC use was associated with a reduction in mortality (RR 0.77; 95% CI 0.67–0.89), all complications (RR 0.56; 95% CI 0.45–0.71) and infectious complications (RR 0.44; 95% CI 0.37–0.52).

Conclusions:

The SSC is used with high fidelity and penetration is associated with improved clinical outcomes in LMICs. Implementation appears well supported by a small number of tailored strategies. Further application of implementation science methodology is required among the global surgical community.
Gesture style can affect the integration of gestures and speech: the evidence from Chinese ERP research
Authors: Sun Fang , Xiang Huiwen , Hu Xinzhuo , Li Yutong , Sui Xue
Published: May 2020

People often accompany gestures in the process of speaking, but the individual’s gesture style is not the same. The present study uses the ambiguity resolution paradigm to explore the influence of two kinds of gesture styles on gesture-verbal comprehension. The study manipulated the gesture styles and meaning types of target words and recorded N400 amplitude. This study found that (1) in the non-grooming condition, compared with the situation where the gesture and semantics are inconsistent, a smaller N400 appears under the consistent condition; (2) in the grooming condition, the grooming gesture will reduce the effect of the iconic gesture on speech understanding. N400 amplitude increased only in the case of matching between dominant meaning gesture and subordinate meaning target word. These results suggest that the communication styles of gestures of different speakers, in the process of speech comprehension, affect how well listeners integrate gestures and language.
Inhibition of PI3K/AKT/mTOR signaling pathway promotes autophagy and relieves hyperalgesia in diabetic rats
Authors: Liu Kang , Yang Yingcong , Zhou Fang , Xiao Yeda , Shi Liwei
Published: May 2020

The purpose of this study was to explore the role and mechanism of the PI3K/AKT/mTOR signaling pathway in painful diabetic neuropathy (PDN). The diabetes mellitus (DM) model was established by intraperitoneal injection of streptozocin into SD rats. After 3 weeks of modeling, the DM + LY group was treated with PI3K inhibitor, the DM + vehicle group was treated with DMSO, and the DM group was untreated. The paw mechanical withdrawal thresholds (MWT) was measured by Von Frey filaments, and the expression of PI3K/AKT/mTOR pathway-related proteins and autophagy marker proteins were analyzed by Western blotting. We found that 3 weeks after modeling, the MWT values of diabetic rats were significantly reduced, p-PI3K, p-AKT and p-mTOR proteins expression in the spinal cord was increased, and Beclin1 and LC3-II expressions were reduced (P < 0.05). After administration of PI3K inhibitor, the MWT values in DM + LY group were improved, and the expressions of p-PI3K, p-AKT and p-mTOR proteins in the spinal cord were decreased significantly, and the expressions of Beclin1 and LC3-II were increased (P < 0.05). However, there were no significant changes in the DM + vehicle group compared with the DM group (P > 0.05). Therefore, we conclude that activation of the PI3K/AKT/mTOR pathway and impaired autophagy may be key factors that cause PDN. Inhibition of the PI3K/AKT/mTOR pathway could promote autophagy activity and alleviate PDN.
Marine mammal skin microbiotas are influenced by host phylogeny
Authors: Apprill Amy , Miller Carolyn A. , Van Cise Amy M. , U'Ren Jana M. , Leslie Matthew S. , Weber Laura , Baird Robin W. , Robbins Jooke , Landry Scott , Bogomolni Andrea , Waring Gordon
Published: May 2020

Skin-associated microorganisms have been shown to play a role in immune function and disease of humans, but are understudied in marine mammals, a diverse animal group that serve as sentinels of ocean health. We examined the microbiota associated with 75 epidermal samples opportunistically collected from nine species within four marine mammal families, including: Balaenopteridae (sei and fin whales), Phocidae (harbour seal), Physeteridae (sperm whales) and Delphinidae (bottlenose dolphins, pantropical spotted dolphins, rough-toothed dolphins, short-finned pilot whales and melon-headed whales). The skin was sampled from free-ranging animals in Hawai‘i (Pacific Ocean) and off the east coast of the United States (Atlantic Ocean), and the composition of the bacterial community was examined using the sequencing of partial small subunit (SSU) ribosomal RNA genes. Skin microbiotas were significantly different among host species and taxonomic families, and microbial community distance was positively correlated with mitochondrial-based host genetic divergence. The oceanic location could play a role in skin microbiota variation, but skin from species sampled in both locations is necessary to determine this influence. These data suggest that a phylosymbiotic relationship may exist between microbiota and their marine mammal hosts, potentially providing specific health and immune-related functions that contribute to the success of these animals in diverse ocean ecosystems.
Apis ceranagut microbiota contribute to host health though stimulating host immune system and strengthening host resistance toNosema ceranae
Authors: Wu Yuqi , Zheng Yufei , Chen Yanan , Chen Gongwen , Zheng Huoqing , Hu Fuliang
Published: May 2020

Gut microbial communities play vital roles in the modulation of many insects' immunity, includingApis mellifera. However, little is known about the interaction ofApis ceranagut bacteria andA. ceranaimmune system. Here in this study, we conducted a comparison between germ-free gut microbiota deficient (GD) workers and conventional gut community (CV) workers, to reveal the possible impact of gut microbiota on the expression ofA. ceranaantimicrobial peptides and immune regulate pathways. We also test whetherA. ceranagut microbiota can strengthen host resistance toNosema ceranae. We find that the expression ofapidaecin,abaecinandhymenoptaecinwere significantly upregulated with the presence of gut bacteria, and JNK pathway was activated; in the meanwhile, the existence of gut bacteria inhibited the proliferation ofNosema ceranae. These demonstrated the essential role ofA. ceranagut microbiota to host health and provided critical insight into the honeybee host–microbiome interaction.
Mechanisms of root reinforcement in soils: an experimental methodology using four-dimensional X-ray computed tomography and digital volume correlation
Authors: Bull D. J. , Smethurst J. A. , Sinclair I. , Pierron F. , Roose T. , Powrie W. , Bengough A. G.
Published: May 2020

Vegetation on railway or highway slopes can improve slope stability through the generation of soil pore water suctions by plant transpiration and mechanical soil reinforcement by the roots. To incorporate the enhanced shearing resistance and stiffness of root-reinforced soils in stability calculations, it is necessary to understand and quantify its effectiveness. This requires integrated and sophisticated experimental and multi-scale modelling approaches to develop an understanding of the processes at different length scales, from individual root–soil interaction through to full soil-profile or slope scale. One of the challenges with multi-scale models is ensuring that they sufficiently closely represent real behaviour. This requires calibration against detailed high-quality and data-rich experiments. This study presents a novel experimental methodology, which combines
in situ
direct shear loading of a willow root-reinforced soil with X-ray computed tomography to capture the three-dimensional chronology of soil and root deformation within the shear zone. Digital volume correlation (DVC) analysis was applied to the computed tomography dataset to obtain full-field three-dimensional displacement and strain information. This paper demonstrates the feasibility and discusses the challenges associated with DVC experiments on root-reinforced soils.
Quantitative SARS-CoV-2 antibody screening of healthcare workers in the southern part of Kyoto city during the COVID-19 peri-pandemic period
Authors: Fujita Kohei , Kada Shinpei , Kanai Osamu , Hata Hiroaki , Odagaki Takao , Satoh-Asahara Noriko , Tagami Tetsuya , Yasoda Akihiro
Published: May 2020

Background

The coronavirus disease-2019 (COVID-19) pandemic is associated with a heavy burden on the mental and physical health of patients, regional healthcare resources, and global economic activity. While our understanding of the incidence and case-fatality rates increases, data on seroprevalence of antibodies against the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in healthcare workers during the peri-pandemic period is insufficient. This study quantitatively evaluated seroprevalence of SARS-CoV-2 antibody in healthcare workers in the southern part of Kyoto city, Japan.

Methods

We prospectively recruited healthcare workers from a single hospital between April 10 and April 20, 2020. We collected serum samples from these participants and quantitatively evaluated SARS-CoV-2 IgG antibody levels by enzyme-linked immunosorbent assay.

Results

Five (5.4%), 15 (16.3%), and 72 (78.3%) participants showed positive, borderline, and negative serum SARS-CoV-2 IgG antibody status, respectively. We found the mean titer associated with each antibody status (overall, positive, borderline, and negative) was clearly differentiated. Participants working at the otolaryngology department and/or having a history of seasonal common cold symptoms had a significantly higher titer of SARS-CoV-2 IgG antibody (p=0.046, p=0.046, respectively).

Conclusions

Five (5.4%) and 15 (16.3%) participants tested positive and borderline, respectively, for SARS-CoV-2 IgG antibody during the COVID-19 peri-pandemic period. These rates were higher than expected based on government situation reports. The present findings suggest that COVID-19 was already spread in the southern part of Kyoto city at the early stage of pandemic.
Did England's Teenage Pregnancy Strategy reduce pregnancy rates in England? A Natural Experiment study
Authors: Baxter Andrew J , Dundas Ruth , Popham Frank , Craig Peter
Published: May 2020

Objective
To re-evaluate the impact of England's Teenage Pregnancy Strategy (1999 to 2010) on pregnancy and birth rates. Hailed as a unique, nation-wide, comprehensive, evidence-based intervention, the strategy has been promoted as a reproducible model for other countries with high teenage pregnancy rates.

Design
Controlled interrupted time series and synthetic control analyses using routinely collected data on births and abortions in 16 countries.

Setting
The Strategy was published in July 1999 and implemented from 2000-2010, with increased investment in areas with higher rates of under-18 pregnancies from 2006 onwards.

Participants
Women aged under 20 living in England during the intervention period were considered to be the target population. Women in Scotland and Wales were the control population in our interrupted time series analyses. Women from European and English-speaking high-income countries were the control population in our synthetic control analyses.

Main outcome measures
The pregnancy rate among women aged under-18 was our primary outcome, as this was the target of the Strategy. We used under-18 births and under-20 pregnancies as secondary outcomes.

Results
In the controlled interrupted time series analyses, trends in rates of teenage pregnancy in England were similar to Scotland (0.08 fewer pregnancies per 1,000 women per year in England; -0.74 to 0.59) and Wales (0.14 more pregnancies per 1,000 women per year in England; -0.48 to 0.76). In synthetic control analyses, under-18 birth rates were very similar in England and the synthetic control. Under-20 pregnancy rates were marginally higher in England than in the synthetic control. Placebo testing and other sensitivity analyses supported the finding of no observable effect.

Conclusion
Although teenage pregnancies and births in England fell following implementation of the Teenage Pregnancy Strategy, comparisons with other countries suggest the strategy had little, if any, effect. The strategy should not be used as a model for future public health interventions in England or in other countries.

The protocol for the analysis was published online at https://osf.io/tdbr8/
Stepping out of lockdown should start with school re-openings while maintaining distancing measures. Insights from mixing matrices and mathematical models.
Authors: McBryde Emma Sue , Trauer James M , Adekunle Adeshina , Ragonnet Romain , Meehan Michael T
Published: May 2020

Australia is one of a few countries which has managed to control COVID-19 epidemic before a major epidemic took place. Currently with just under 7000 cases and 100 deaths, Australia is seeing less than 20 new cases per day. This is a positive outcome, but makes estimation of current effective reproduction numbers difficult to estimate. Australia, like much of the world is poised to step out of lockdown and looking at which measures to relax first.
We use age-based contact matrices, calibrated to Chinese data on reproduction numbers and difference in infectiousness and susceptibility of children to generate next generation matrices (NGMs) for Australia. These matrices have a spectral radius of 2.49, which is hence our estimated basic reproduction number for Australia. The effective reproduction number (Reff) for Australia during the April/May lockdown period is estimated by other means to be around 0.8. We simulate the impact of lockdown on the NGM by first applying observations through Google Mobility Report for Australia at 3 locations: home (increased contacts by 18%), work (reduced contacts by 34%) and other (reduced contacts by 40%), and we reduce schools to 3% reflecting attendance rates during lockdown. Applying macro-distancing to the NGM leads to a spectral radius of 1.76. We estimate that the further reduction of the reproduction number to current levels of Reff = 0.8 is achieved by a micro-distancing factor of 0.26. That is, in a given location, people are 26% as likely as usual to have an effective contact with another person.
We apply both macro and micro-distancing to the NGMs to examine the impact of different exit strategies. We find that reopening schools is estimated to reduce Reff from 0.8 to 0.78. This is because increase in school contact is offset by decrease in home contact. The NGMs all estimate that adults aged 30-50 are responsible for the majority of transmission. We also find that micro-distancing is critically important to maintain Reff <1. There is considerable uncertainty in these estimates and a sensitivity and uncertainty analysis is presented.
Silent Disease and Loss of Taste and Smell are Common Manifestations of SARS-COV-2 Infection in a Quarantine Facility: Saudi Arabia
Authors: Alshami Alanoud , Alattas Rabab , Anan Hadeel , Qahtani Hadi Al , Alahilm Abdulbari , Mulhim Mobarak Al , Alfaraj Ahmed
Published: May 2020

BACKGROUND

The Coronavirus disease 2019 (COVID-19) outbreak in Saudi Arabia was first identified in a traveler from Al Qatif city, on March 2nd, 2020. The disease has quickly spread and reached multiple cities within a few weeks. In an attempt to limit the spread of COVID-19 in Saudi Arabia, the government has implemented strict regulations. Starting March 15th, all travelers coming back to the kingdom were tested for COVID-19 and were quarantined in a government-designated facility. The same rule was applied to all positive cases identified by contact tracing. In this study, we aimed to assess the prevalence of asymptomatic carriers, epidemiological characteristics, clinical presentations, and viral clearance of SARS-COV-2 positive quarantined individuals in a quarantine facility in the eastern province.

METHODS

We conducted a cross-sectional study on 128 laboratory-confirmed COVID-19 subjects who were quarantined in a government-designated facility. The study period was from March 16th – till April 18th, 2020. We collected data on demographics and on clinical symptoms. Also, samples for PCR tests were collected upon admission and were repeated every 72 hours if they were still positive. All negative samples were repeated within 24 hours for confirmation.

RESULTS

Sixty-nine of the 128 residents (54%) were completely asymptomatic until the end of the study. The remaining 59 residents (46%) had only mild symptoms. The most common symptom was a sudden loss of smell and taste, accounting for 47.5%. The median time to virus clearance was significantly different between the two groups. Symptomatic residents cleared the virus at a median of 17 days (95% CI,12.4-21.6) from the first positive PCR vs. 11days (95% CI, 8.7-13.3) in the asymptomatic group (P=0.011). False-negative test results occurred in 18.8% of the total residents and false positive results in 3%.

CONCLUSION

The prevalence of asymptomatic carriers is high in our study. Testing, and isolating travelers and contacts of laboratory-confirmed cases, regardless of symptoms, were very effective measures for early disease identification and containment. Loss of taste and smell was the most common presentation in our mild symptomatic residents, and it might be predictive of mild disease. The persistent positive PCR beyond 14 days observed in the mild symptomatic residents despite being symptoms free, warrant further studies to determine its implications on disease spread and control.
Clinical characteristics and early outcomes in patients with COVID-19 treated with tocilizumab at a United States academic center
Authors: Rimland Casey A. , Morgan Camille E. , Bell Griffin J. , Kim Min K. , Hedrick Tanner , Marx Ashley , Bramson Brian , Swygard Heidi , Napravnik Sonia , Schmitz John L. , Carson Shannon S. , Fischer William A. , Eron Joseph J. , Gay Cynthia L. , Parr Jonathan B.
Published: May 2020

We describe early outcomes in 11 COVID-19 patients treated with the IL-6 receptor inhibitor tocilizumab. While C-reactive protein decreased, neither clinical improvement nor reduced temperature or oxygen requirements was observed in most patients. Our findings contrast with prior reports and raise questions about tocilizumab use in severe COVID-19.