bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining Expertise in Cancer Nursing Practice
Authors: Krishnasamy Mei , Webb Ursula M. M. , Babos Susannah L. C. , Duong Jessica T. T. , Rohde Jacqueline E. N. , Ting Nathan Y. H. , Milne Donna , Koproski Trista , Mathieson Jac
Published: March 2020

Background

Thirty-five years ago, Benner defined an expert nurse as one who applies deep knowledge and experience across different contexts and clinical situations. Since that time, there has been little exploration of expertise in cancer nursing.

Objectives

To explore and describe characteristics of expert cancer nurses and to consider whether Benner’s typology of an expert nurse remains relevant in today’s complex oncology settings.

Methods

An exploratory, descriptive study using audio-recorded focus group methodology was undertaken. Audio-recordings were transcribed, and an inductive thematic analysis approach applied to the data. Nurses also documented key characteristics of expert practice on Post-it notes to illustrate dominant characteristics.

Results

Twenty-four registered nurses from a comprehensive cancer center in Australia took part in 1 of 3 focus groups. Seven key themes were identified: knowledge, leadership, adaptability, communication, motivation, patient-centered care, organization, and culture. Key word cloud characteristics included knowledge, compassion, motivation, experience, and communication.

Conclusions

Many of the expert characteristics identified in this study reflect traits common to other nursing specialty groups. Of particular relevance to cancer nurses was “adaptability,” reflecting the complexity of contemporary cancer care and reaffirming Benner’s definition of an expert nurse as one who can fluidly connect knowledge and experience to unfamiliar practice contexts.

Implications for Practice

Understanding characteristics of expert cancer nurses may help inform and support professional practice advancement and guide future research about select characteristics of expert cancer nurses to patient- and system-level outcomes.
A Psychological Nursing Intervention for Patients With Thyroid Cancer on Psychological Distress and Quality of Life
Authors: Wang Shujia , Huang Hui , Wang Liping , Wang Xiaoyan
Published: March 2020

The present research aimed to investigate the impact of a psychological nursing intervention on psychological distress and quality of life of thyroid cancer patients. A total of 286 participants were randomly divided into two groups: a control group (n = 143) and an intervention group (n = 143). In addition to routine nursing care, patients in the intervention group were given additional psychological nursing interventions. A reduced edition of the Profile of Mood States was used to evaluate mood disturbance, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core Questionnaire (version 3.0) was applied to determine the quality of life of patients. The intervention group showed remarkably alleviated depression, anxiety, and mood disturbance when compared to the control group. In addition, global health status, functional status, and symptoms status were significantly improved in the intervention group. In conclusion, our findings suggest that a psychological nursing intervention could reduce psychological distress and enhance the life quality of thyroid cancer patients, which could have clinical value to the treatment of thyroid cancer.
Improving Patient Discharge Education Through Daily Educational Bursts
Authors: St. John Isabelle J. , Englund Heather M.
Published: March 2020

The purpose of this study was to investigate the impact that daily discharge education “bursts” using the teach-back method had on participants’ confidence levels in their self-care management abilities. Daily educational bursts positively impacted participants’ self-confidence in their postdischarge self-care management abilities. Nursing professional development practitioners could use the results of this study to address the inconsistency of providing effective, daily discharge education for patients.
EPR17341 and A7H6R pan-TRK Immunohistochemistry Result in Highly Different Staining Patterns in a Series of Salivary Gland Tumors
Authors: Guibourg Briac , Cloarec Emma , Conan-Charlet Virginie , Quintin-Roué Isabelle , Grippari Jean-Luc , Le Flahec Glen , Marcorelles Pascale , Uguen Arnaud
Published: March 2020

Patients with NTRK-rearranged tumors can be now treated using anti-TRK–targeted therapies making NTRK testing important for treatment choices in patients with advanced cancers. Pan-TRK immunohistochemistry (IHC) could be a valuable premolecular screening strategy in this field. The choice of 1 IHC method or another requires to investigate for intermethod comparison. A high frequency of pan-TRK positive tumors among salivary gland tumors makes these tumors particularly appropriate for such a technical study. In this work, we studied the intermethod agreement for 2 pan-TRK IHC methods (using A7H6R and EPR17341 clones) in a file of salivary gland tumors of different subtypes. Among 71 tumors, pan-TRK IHC was diagnosed as positive (ie, H score ≥5) in 23 and 18 cases using EPR17341 and A7H6R clones, respectively, with a good intermethod agreement in terms of positive/negative result (κ, 0.70) but only a moderate agreement considering the H score values themselves (intraclass correlation coefficient of 0.5399). Beyond the intensity of staining and the percentages of stained cells, major differences were also observed between the location and type of cells stained in positive cases between the 2 clones. The single NTRK-rearranged case in our series (ie, a NTRK3-rearranged salivary secretory carcinoma) was positive with the 2 pan-TRK antibodies. Future studies including molecularly proven NTRK-rearranged tumors remain required to further study and compare the performances of different pan-TRK clones in the screening of NTRK-rearranged cancers but it is now obvious that the staining patterns of A7H6R and EPR17341 clones are not strictly identical.
Pure Primary Ovarian Carcinoid Tumor
Authors: Halvorson Tracy S. , Robinson Robert A. , Samuelson Megan I.
Published: March 2020

Primary ovarian carcinoid tumors are uncommon neoplasms that typically arise in the context of a mature cystic teratoma. Pure primary ovarian carcinoid tumors (PPOCTs) are rare and present as a solid ovarian mass in which, by definition, elements of an associated teratoma or other neoplasm are absent. We report a case of a middle-aged woman who presented with abdominal distension. Computed tomography identified a 20 cm abdominopelvic mass. The patient underwent exploratory laparotomy, hysterectomy, and bilateral salpingo-oophorectomy. A large, solid, yellow-tan ovarian mass was resected and diagnosed as a PPOCT. Para-aortic lymph node metastases were identified. This case highlights the gross and microscopic findings characteristic of PPOCTs. In addition, the large number of differential considerations for an insular PPOCT at intraoperative evaluation are discussed.
Retrospective Analysis of Fractures and Factors Causing Ambulation Loss After Lower Limb Fractures in Duchenne Muscular Dystrophy
Authors: Yildiz Sulenur , Glanzman Allan M. , Estilow Tim , Flickinger Jean , Brandsema John F. , Tennekoon Gihan , Banwell Brenda L. , Yum Sabrina
Published: March 2020

Objective

Prevalence and characteristics of fractures and factors related to loss of ambulation after lower limb fractures were investigated.

Design

Chart review included height, weight, dual-energy x-ray absorptiometry, corticosteroid use, vitamin D, fracture history, muscle strength, range of motion, and timed performance tests (10 meter walk/run, Gowers, and four steps). Patients were grouped by fracture location and ambulation loss after fracture.

Results

Two hundred eighty-seven patients with Duchenne muscular dystrophy were identified, 53 of these had experienced fracture. Eighty-one percent were older than 9 yrs at first fracture and 36.4% became nonambulatory after fracture. Dorsiflexion range of motion (fracture side,P= 0.021), quadriceps strength (right side,P= 0.025), and shoulder abduction strength (right, left, and fracture side;P= 0.028,P= 0.027, andP= 0.016) were significantly different within the groups. Patients who became nonambulatory after fracture initially had less dorsiflexion (right, left, fracture side; 2.250vs. −7.290,P= 0.004; 2.670vs. −120,P= 0.001; and 2.410vs. −7.420,P= 0.002) and slower 10-meter walk/run times (7.43 secs vs. 14.7 secs,P= 0.005).

Conclusions

Fracture represents a significant risk in patients with Duchenne muscular dystrophy; both slower walking speed and ankle contracture confer an increased risk of ambulation loss after fracture.

To Claim CME Credits

Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives

Upon completion of this article, the reader should be able to: (1) Identify the main factors that are associated with ambulation loss after fracture in patients with Duchenne muscular dystrophy; (2) Identify the risk of fracture in the Duchenne muscular dystrophy population; and (3) Articulate the characteristics associated with fracture in patients with Duchenne muscular dystrophy.

Level

Advanced.

Accreditation

The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Functional Outcomes Regarding Facial Artery Musculomucosal Flap for Reconstruction of Partial Glossectomy Defects
Authors: Benjamin Martin , Aliano Kristen , Davenport Thomas , Frank Douglas
Published: March 2020

Background

The surgical management and reconstruction after ablation of squamous cell carcinoma of the oral tongue and floor of mouth are quite challenging. If not reconstructed properly, the deficits resulting from the extirpation of even relatively small (T1 and T2) tumors of the tongue can impact speech and deglutition via tongue tethering and poor anterolateral mobility. Functional outcome studies regarding the utility of the pedicled facial artery musculamucosal (FAMM) flap for reconstruction of partial glossectomy defects are limited.

Methods

This is a retrospective single institutional study of patients who underwent FAMM flap reconstruction for oral cavity defects resulting from partial glossectomy (2009–2013). Follow-up data included postoperative complications, defect size, operative time, and subjective functional results (tongue mobility, speech, and swallowing capabilities).The MD Anderson Dysphagia Inventory and a limited self-assessment of speech were sent to all living patients in this initial tongue cancer cohort to assess aspects of functional status.

Results

Of the 21 patients studied in this initial FAMM flap cohort, 18 are currently living. The MD Anderson Dysphagia Inventory and a limited self-assessment survey of speech were sent to these individuals 6 months after treatment completion. Eight patients (44%) returned completed questionnaires. All of the respondents disagreed or strongly disagreed with the statement that they felt excluded from others because of their eating habits, 6 of the 8 of the respondents stated that they disagreed or strongly disagreed with the statement that they have to limit their food intake, and none felt that others were irritated by their eating habits. All felt that their speech was either good, very good, or excellent. No surveyed patient reported having job difficulty because of their speech.

Conclusions

The FAMM flap is a reliable alternative for reconstruction of small oral tongue defects without functional deficits and a great alternative to free flap reconstruction of medium-sized defects. The encouragement of patient functional outcome studies and longitudinal follow-up studies need to be conducted in efforts to best tailor a reconstruction plan for patients with oral tongue cancers.
Preferences of Transgender and Gender-Nonconforming Persons in Gender-Confirming Surgical Care
Authors: Margulies Ilana G. , Chuang Carolyn , Travieso Roberto , Zhu Victor , Persing John A. , Steinbacher Derek M. , Zellner Elizabeth G.
Published: March 2020

Introduction

Increased awareness for transgender and gender-nonconforming individuals may lead to increased demand for surgical interventions in gender-confirming care. However, limited literature exists regarding transgender and gender-nonconforming preferences and experiences with medical or surgical care. The authors aim to characterize the medical and surgical care sought by this population, as well as their surgical preferences, motivations, and barriers to care.

Methods

An online questionnaire about opinions and personal experiences with medical and surgical care during gender transition was publicized via regional online social networking forums in Connecticut and surrounding areas catering to transgender communities.

Results

Responses were received from 313 participants. Participants were 97% male gender at birth and 92% white with an average (SD) age of 51.6 (13.5) years. Fifty-nine percent identified as male-to-female transgender and 20% as gender nonconforming. Respondents were aware of their gender identity at a mean (SD) age of 9.6 (9.0) years, but did not begin transitioning until a mean (SD) age of 38.9 (20.8) years, with gender-nonconforming respondents choosing to transition at a significantly younger age as compared with transgender respondents (29.8 vs 41.4 years; P = 0.0061, unpaired t test). Only 42% of all respondents, with a significantly greater number of transgender as opposed to gender-nonconforming individuals, had previously met with a physician to discuss transitioning (49% vs 21%, P = 0.002, χ2 test). Eight percent of the study population had undergone gender confirmation surgery (GCS), 52% were interested in GCS, and 40% were not interested in GCS. Primary motivation for GCS included discomfort in one's current body (28%), and barriers to GCS included cost (40%) and reactions of family (40%), partners (32%), and friends (25%).

Conclusions

Transgender and gender-nonconforming individuals lack medical support for gender transition, with fewer than half of survey respondents reporting a prior meeting with a physician to discuss transitioning. The reported perspectives offer important insight into transgender preferences that should act as the basis of future efforts to improve the efficacy of gender-confirming care.
Complement as a Major Inducer of Harmful Events in Infectious Sepsis
Authors: Fattahi Fatemeh , Zetoune Firas S. , Ward Peter A.
Published: March 2020

There is abundant evidence that infectious sepsis both in humans and mice with polymicrobial sepsis results in robust activation of complement. Major complement activation products involved in sepsis include C5a anaphylatoxin and its receptors (C5aR1 and C5aR2) and, perhaps, the terminal complement activation product, C5b-9. These products (and others) also cause dysfunction of the innate immune system, with exaggerated early proinflammatory responses, followed by decline of the innate immune system, leading to immunosuppression and multiorgan dysfunction. Generation of C5a during sepsis also leads to activation of neutrophils and macrophages and ultimate appearance of extracellular histones, which have powerful proinflammatory and prothrombotic activities. The distal complement activation product, C5b-9, triggers intracellular Ca2+ fluxes in epithelial and endothelial cells. Histones activate the NLRP3 inflammasome, products of which can damage cells. C5a also activates MAPKs and Akt signaling pathways in cardiomyocytes, causing buildup of [Ca2+]i, defective action potentials and substantial cell dysfunction, resulting in cardiac and other organ dysfunction. Cardiac dysfunction can be quantitated by ECHO-Doppler parameters. In vivo interventions that block these complement-dependent products responsible for organ dysfunction in sepsis reduce the intensity of sepsis. The obvious targets in sepsis are C5a and its receptors, histones, and perhaps the MAPK pathways. Blockade of C5 has been considered in sepsis, but the FDA-approved antibody (eculizumab) is known to compromise defenses against neisseria and pneumonococcal bacteria, and requires immunization before the mAb to C5 can be used clinically. Small molecular blocking agents for C5aRs are currently in development and may be therapeutically effective for treatment of sepsis.
Identifying Septic Shock Populations Benefitting From Polymyxin B Hemoperfusion: A Prospective Cohort Study Incorporating a Restricted Cubic Spline Regression Model
Authors: Nakata Hidekazu , Yamakawa Kazuma , Kabata Daijiro , Umemura Yutaka , Ogura Hiroshi , Gando Satoshi , Shintani Ayumi , Shiraishi Atsushi , Saitoh Daizoh , Fujishima Seitaro , Mayumi Toshihiko , Kushimoto Shigeki , Abe Toshikazu , Shiino Yasukazu , Nakada Taka-aki , Tarui Takehiko , Hifumi Toru , Otomo Yasuhiro , Okamoto Kohji , Kotani Joji , Sakamoto Yuichiro , Sasaki Junichi , Shiraishi Shin-ichiro , Takuma Kiyotsugu , Tsuruta Ryosuke , Hagiwara Akiyoshi , Masuno Tomohiko , Takeyama Naoshi , Yamashita Norio , Ikeda Hiroto , Ueyama Masashi , Fujimi Satoshi
Published: March 2020

Introduction:

Polymyxin B hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that removes circulating endotoxin. However, PMX-HP has seldom achieved expectations in randomized trials targeting nonspecific overall sepsis patients. If used in an optimal population, PMX-HP may be beneficial. This study aimed to identify the optimal population for PMX-HP in patients with septic shock.

Methods:

We used a prospective nationwide cohort targeting consecutive adult patients with severe sepsis (Sepsis-2) in 59 intensive care units in Japan. Associations between PMX-HP therapy and in-hospital mortality were assessed using multivariable Cox proportional hazard regression models. To identify best targets for PMX-HP, we developed a non-linear restricted cubic spline model including two-way interaction term (treatment × Acute Physiology and Chronic Health Evaluation [APACHE] II score/Sequential Organ Failure Assessment [SOFA] score) and three-way interaction term (treatment × age × each score).

Results:

The final study cohort comprised 741 sepsis patients (92 received PMX-HP, 625 did not). Cox proportional hazards regression model adjusted for the covariates suggested no association between PMX-HP therapy and improved mortality overall. Effect modification of PMX-HP by APACHE II score was statistically significant (P for interaction = 0.189) but non-significant for SOFA score (P for interaction = 0.413). Three-way interaction analysis revealed suppressed risk hazard in the PMX-HP group versus control group only in septic shock patients with high age and in the most severe subset of both scores, whereas increased risk hazard was observed in those with high age but in the lower severity subset of both scores.

Conclusions:

Our results suggested that although PMX-HP did not reduce in-hospital mortality among overall septic shock patients, it may benefit a limited population with high age and higher disease severity.
Efficacy and Safety of Tocilizumab in the Treatment of Acute Active Antibody-mediated Rejection in Kidney Transplant Recipients
Authors: Pottebaum April A. , Venkatachalam Karthikeyan , Liu Chang , Brennan Daniel C. , Murad Haris , Malone Andrew F. , Alhamad Tarek
Published: March 2020

Background.

Antibody-mediated rejection (AMR) continues to have a deleterious impact on kidney allograft survival. Recent evidence supports use of tocilizumab for treatment of chronic active AMR, but it has not been assessed for treatment of acute active AMR.

Methods.

We performed a single-center, observational study of kidney transplant recipients who received at least 1 dose of tocilizumab in addition to conventional therapies for acute active AMR between October 2016 and October 2018 with follow-up through August 2019.

Results.

Seven patients were included. All 7 patients received tocilizumab 8 mg/kg (max dose, 800 mg) monthly. We noted a 50% or greater reduction in immunodominant donor-specific antibodies in 4 of 6 patients. Renal function improved or stabilized in all patients throughout the duration of therapy. One patient developed cytomegalovirus esophagitis and 1 had a potential hypersensitivity reaction. In the extended follow-up, 1 patient had mixed rejection and 2 patients had T-cell–mediated rejection, which occurred 6 to 24 mo after completion of therapy.

Conclusions.

Tocilizumab may be considered as an addition to conventional therapies for treatment of acute active AMR. More studies are needed to determine which patients may benefit from therapy and to examine the appropriate duration of treatment.
Analysis of an Unusual Case of Nonfluent Aphasia With Predominantly Posterior Perisylvian Lesion: An Apparent Paradox
Authors: Lahiri Durjoy , Ardila Alfredo , Dubey Souvik , Ray Biman K.
Published: March 2020

Lesion site–aphasia type discordance has garnered increasing interest in cognitive neuroscience over the last century. Diaschisis, the network concept of cognitive functions, and interindividual variability are among the plausible explanations cited in the literature for such unusual clinical cases. We describe here the case of a nonfluent type of aphasia following an ischemic stroke predominantly affecting the left posterior perisylvian cortex in a right-handed Bengali-speaking woman. The patient’s comprehension was well preserved; however, she presented with a severe motor speech defect. MRI revealed an ischemic lesion in the left parietotemporal area, with slight involvement of the postero-inferior frontal cortex. We suggest two plausible explanations for this lesion-aphasia discordance: Our patient had bilateral representation of language receptive functions in her brain, and additional areas neighboring the classical Broca area may support some critical mechanisms of speech production. Taken together, these explanations may clarify why our patient was able to maintain the ability to decode language even though her language production was significantly affected.
A Case of Right Temporal Lobectomy for Brain Tumor With Selective Semantic Pictorial Disorder
Authors: Gainotti Guido , Bonnì Sonia , Maiella Michele , Carretta Jessica , Zigiotto Luca , Sarubbo Silvio , Papagno Costanza
Published: March 2020

Disagreement exists regarding representational and connectionist interpretations of semantic knowledge subserved by the right versus left anterior temporal lobes (ATLs). These interpretations predict a different pattern of impairment in patients with a right unilateral ATL lesion. We conducted a neuropsychological study of a selective semantic pictorial defect exhibited by a 57-year-old man who had undergone a right temporal lobectomy due to the presence of a glioblastoma. The patient was given the Thematic and Taxonomic Semantic task, in which individuals must select, within triplets of words or pictures, the best associates of living or nonliving stimuli, related by thematic or taxonomic links, and presented in the verbal or pictorial modality. The selectivity of the defect was documented by a comparison between the results obtained by our patient and those obtained by healthy controls on living items and on pictures with a thematic relation. The selectivity of the defect was confirmed by a within-subject analysis of the results obtained on all of the task’s triplets and those obtained on the stimuli representing living entities with a taxonomic relation. The selectivity of this semantic pictorial defect mainly concerning living entities is consistent with the representational account of semantic defects observed in our patient. In the present case report, a right temporal lobectomy resulted in a selective semantic pictorial defect with the qualitative features predicted by the representational account of semantic defects observed after a unilateral ATL lesion.
Sibling quality and the haplodiploidy hypothesis
Authors: Kennedy P. , Radford A. N.
Published: March 2020

The ‘haplodiploidy hypothesis’ argues that haplodiploid inheritance in bees, wasps, and ants generates relatedness asymmetries that promote the evolution of altruism by females, who are less related to their offspring than to their sisters (‘supersister’ relatedness). However, a consensus holds that relatedness asymmetry can only drive the evolution of eusociality if workers can direct their help preferentially to sisters over brothers, either through sex-ratio biases or a pre-existing ability to discriminate sexes among the brood. We show via a kin selection model that a simple feature of insect biology can promote the origin of workers in haplodiploids without requiring either condition. In insects in which females must found and provision new nests, body quality may have a stronger influence on female fitness than on male fitness. If altruism boosts the quality of all larval siblings, sisters may, therefore, benefit more than brothers from receiving the same amount of help. Accordingly, the benefits of altruism would fall disproportionately on supersisters in haplodiploids. Haplodiploid females should be more prone to altruism than diplodiploid females or males of either ploidy when altruism elevates female fitness especially, and even when altruists are blind to sibling sex.
Anne Marie Treisman. 27 February 1935—9 February 2018
Authors: Kahneman Daniel , Treisman Deborah
Published: March 2020

The psychologist Anne Treisman dedicated her career to the study of attention and perception, a central concern of cognitive science. While still a graduate student, she modified and reformulated the leading theory of auditory attention. Her discoveries and insights into the role of visual attention in the perception of objects, to which she devoted her subsequent decades of research, have had a lasting influence, not only in experimental psychology but also in vision research, neuroscience and artificial intelligence. In a period of rising interest in the brain, her foundational theories inspired thousands of experiments in her own field and others, and the originality and precision of her experimental design confirmed the continued relevance of behavioural research to the scientific enterprise. Treisman's accomplishments were recognized by the National Academy of Sciences in the USA in 1994 and by the American Academy of Arts and Sciences in 1995. In 1996, she became the first psychologist to win the Golden Brain Award. She received the University of Louisville Grawemeyer Award in Psychology in 2009, and was awarded the National Medal of Science by President Barack Obama at a White House ceremony in 2013.
Guy Dodson. 13 January 1937—24 December 2012
Authors: Dodson Eleanor
Published: March 2020

Guy Dodson's scientific reputation is based on his seminal contributions to linking chemistry and biology through analyses of three-dimensional structures elucidated by crystallography. He inspired and supported the development of new methods to determine structure, to relate structure to chemical mechanism and to embed structural insights into the lexicon of biological research. He began his career working with Dorothy Hodgkin, at the University of Oxford, and in later life he set up two very successful structural biology laboratories, at the University of York and then at the National Institute of Medical Research, Mill Hill. He is particularly remembered for his research into improving insulin therapy, based on modifications suggested by structural insights. He showed early recognition of how to build synergy in industrial collaborations that led both to fundamental scientific discoveries and to the development of new medicines and products to benefit society. He is also remembered for the enthusiasm he brought to these studies, for the pleasure he got, and gave, from the successes of others, and his generosity of spirit.
Symbolic transfer entropy reveals the age structure of pandemic influenza transmission from high-volume influenza-like illness data
Authors: Kissler Stephen M. , Viboud Cécile , Grenfell Bryan T. , Gog Julia R.
Published: March 2020

Existing methods to infer the relative roles of age groups in epidemic transmission can normally only accommodate a few age classes, and/or require data that are highly specific for the disease being studied. Here, symbolic transfer entropy (STE), a measure developed to identify asymmetric transfer of information between stochastic processes, is presented as a way to reveal asymmetric transmission patterns between age groups in an epidemic. STE provides a ranking of which age groups may dominate transmission, rather than a reconstruction of the explicit between-age-group transmission matrix. Using simulations, we establish that STE can identify which age groups dominate transmission even when there are differences in reporting rates between age groups and even if the data are noisy. Then, the pairwise STE is calculated between time series of influenza-like illness for 12 age groups in 884 US cities during the autumn of 2009. Elevated STE from 5 to 19 year-olds indicates that school-aged children were likely the most important transmitters of infection during the autumn wave of the 2009 pandemic in the USA. The results may be partially confounded by higher rates of physician-seeking behaviour in children compared to adults, but it is unlikely that differences in reporting rates can explain the observed differences in STE.
Comparative Performance of SARS-CoV-2 Detection Assays using Seven Different Primer/Probe Sets and One Assay Kit
Authors: Casto Amanda M. , Huang Meei-Li , Nalla Arun , Perchetti Garrett , Sampoleo Reigran , Shrestha Lasata , Wei Yulun , Zhu Haiying , Greninger Alexander L. , Jerome Keith R.
Published: March 2020

More than 100,000 people worldwide are known to have been infected with SARS-CoV-2 beginning in December 2019. The virus has now spread to over 93 countries including the United States, with the largest cluster of US cases to date in the Seattle metropolitan area in Washington. Given the rapid increase in the number of local cases, the availability of accurate, high-throughput SARS-CoV-2 testing is vital to efforts to manage the current public health crisis. In the course of optimizing SARS-CoV-2 testing performed by the University of Washington Clinical Virology Lab (UW Virology Lab), we tested assays using seven different primer/probe sets and one assay kit. We found that the most sensitive assays were those the used the E-gene primer/probe set described by Corman et al. (Eurosurveillance 25(3), 2020, https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045) and the N2 set described by the CDC (Division of Viral Diseases, Centers for Disease Control and Prevention, 2020, https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-primer-probes.pdf). All assays tested were found to be highly specific for SARS-CoV-2, with no cross-reactivity with other respiratory viruses observed in our analyses regardless of the primer/probe set or kit used. These results will provide invaluable information to other clinical laboratories who are actively developing SARS-CoV-2 testing protocols at a time when increased testing capacity is urgently needed worldwide.
Assessment of public attention, risk perception, emotional and behavioural responses to the COVID-19 outbreak: social media surveillance in China
Authors: Hou Zhiyuan , Du Fanxing , Jiang Hao , Zhou Xinyu , Lin Leesa
Published: March 2020

Background

Using social media surveillance data, this study aimed to assess public attention, risk perception, emotion, and behavioural response to the COVID-19 outbreak in real time.

Methods

We collected data from most popular social medias: Sina Weibo, Baidu search engine, and Ali e-commerce marketplace, from 1 Dec 2019 to 15 Feb 2020. Weibo post counts and Baidu searches were used to generate indices assessing public attention. Public intention and actual adoption of recommended protection measures or panic buying triggered by rumours and misinformation were measured by Baidu and Ali indices. Qualitative Weibo posts were analysed by the Linguistic Inquiry and Word Count text analysis programme to assess public emotion responses to epidemiological events, governments’ announcements, and control measures.

Findings

We identified two missed windows of opportunity for early epidemic control of the COVID-19 outbreak, one in Dec 2019 and the other between 31 Dec and 19 Jan, when public attention was very low despite the emerging outbreak. Delayed release of information ignited negative public emotions. The public responded quickly to government announcements and adopted recommended behaviours according to issued guidelines. We found rumours and misinformation regarding remedies and cures led to panic buying during the outbreak, and timely clarification of rumours effectively reduced irrational behaviour.

Interpretation

Social media surveillance can enable timely assessments of public reaction to risk communication and epidemic control measures, and the immediate clarification of rumours. This should be fully incorporated into epidemic preparedness and response systems.

Funding

National Natural Science Foundation of China.
CoViD–19: An Automatic, Semiparametric Estimation Method for the Population Infected in Italy
Authors: Fenga Livio
Published: March 2020

To date, official data on the number of people infected with the SARS-CoV-2 - responsible for the CoViD–19 - have been released by the Italian Government just on the basis of a non representative sample of population which tested positive for the swab. However a reliable estimation of the number of infected, including asymptomatic people, turns out to be crucial in the preparation of operational schemes and to estimate the future number of people, who will require, to different extents, medical attentions. In order to overcome the current data shortcoming, this paper proposes a bootstrap–driven, estimation procedure for the number of people infected with the SARS-CoV-2. This method is designed to be robust, automatic and suitable to generate estimations at regional level. Obtained results show that, while official data at March the 12th report 12.839 cases in Italy, people infected wiyh the SARS-CoV-2 could be as high as 105.789.
Blood single cell immune profiling reveals the interferon-MAPK pathway mediated adaptive immune response for COVID-19
Authors: Huang Lulin , Shi Yi , Gong Bo , Jiang Li , Liu Xiaoqi , Yang Jialiang , Tang Juan , You Chunfang , Jiang Qi , Long Bo , Zeng Tao , Luo Mei , Zeng Fanwei , Zeng Fanxin , Wang Shuqiang , Yang Xingxiang , Yang Zhenglin
Published: March 2020

The coronavirus disease 2019 (COVID-19) outbreak is an ongoing global health emergence, but the pathogenesis remains unclear. We revealed blood cell immune response profiles using 5’ mRNA, TCR and BCR V(D)J transcriptome analysis with single-cell resolution. Data from 134,620 PBMCs and 83,387 TCR and 12,601 BCR clones was obtained, and 56 blood cell subtypes and 23 new cell marker genes were identified from 16 participants. The number of specific subtypes of immune cells changed significantly when compared patients with controls. Activation of the interferon-MAPK pathway is the major defense mechanism, but MAPK transcription signaling is inhibited in cured patients. TCR and BCR V(D)J recombination is highly diverse in generating different antibodies against SARS-CoV-2. Therefore, the interferon-MAPK pathway and TCR-and BCR-produced antibodies play important roles in the COVID-19 immune response. Immune deficiency or immune over-response may result in the condition of patients with COVID-19 becoming critical or severe.
The clinical and epidemiological features and hints of 82 confirmed COVID-19 pediatric cases aged 0-16 in Wuhan, China
Authors: Yu Hui , Cai Qinzhen , Dai Xiang , Liu Xiuzhen , Sun Hong
Published: March 2020

Although COVID-19 pediatric patients just account for 1% of the overall cases, they are nonnegligible invisible infection sources. We quantitatively analyzed the clinical and epidemiological features of 82 confirmed cases aged 0-16 admitted to Wuhan Children’s Hospital, which are expected to shed some lights onto the pediatric diagnosis and therapy.
Coronavirus disease-19: Summary of 2,370 Contact Investigations of the First 30 Cases in the Republic of Korea
Authors:   COVID-19 National Emergency Response Center, Epidemiology and Case Management Team, Korea Centers for Disease Control and Prevention
Published: March 2020

Between January 24 and March 10, of a total of 2,370 individuals who had contacted the first 30 cases of COVID-19, 13 were found to have COVID-19, resulting secondary attack rate of 0.55% (95% CI 0.31 – 0.96). Of 119 household contacts, 9 had infections resulting secondary attack rate of 7.56 (95% CI 3.73 – 14.26).
Coronavirus disease-19: The First 7,755 Cases in the Republic of Korea
Authors:   COVID-19 National Emergency Response Center, Epidemiology Center, Epidemiology & and Case management team, Korea Centers for Disease Control and Prevention
Published: March 2020

We report the first 7,755 patients with confirmed COVID-19 in Korea as of March 13, 2020. A total of 66 deaths were identified, resulting case fatality proportion of 0.9%. Older people, and those with coexisting medical conditions were at risk for fatal outcomes. The highest number of cases were from Daegu, followed by Gyeongbuk, with elevated age-stratified case fatality. This summary may help to understand the disease dynamics in the early phase of COVID-19 outbreak, therefore, to guide future public health measures.
Effect of large-scale testing platform in prevention and control of the COVID-19 pandemic: an empirical study with a novel numerical model
Authors: Xie Qing , Wang Jing , You Jianling , Zhu Shida , Zhou Rui , Tian Zhijian , Wu Hao , Lin Yang , Chen Wei , Xiao Lan , Jin Xin , Li Jianjuan , Dong Jie , Wu Honglong , Zhang Wei , Li Jing , Xu Xun , Yin Ye , Mu Feng , Chen Weijun , Jian Wang
Published: March 2020

Background

China adopted an unprecedented province-scale quarantine since January 23rd 2020, after the novel coronavirus (COVID-19) broke out in Wuhan in December 2019. Responding to the challenge of limited testing capacity, large-scale standardized and fully-automated laboratory (Huo-Yan) was built as an ad-hoc measure. There was so far no empirical data or mathematical model to reveal the impact of the testing capacity improvement since the quarantine.

Methods

We integrated public data released by the Health Commission of Hubei Province and Huo-Yan Laboratory testing data into a novel differential model with non-linear transfer coefficients and competitive compartments, to evaluate the trends of suspected cases under different nucleic acid testing capacities.

Results

Without the establishment of Huo-Yan, the suspected cases would increased by 47% to 33,700, the corresponding cost of the quarantine would be doubled, and the turning point of the increment of suspected cases and the achievement of “daily settlement” (all daily new discovered suspected cases were diagnosed according to the nucleic acid testing results) would be delayed for a whole week and 11 days. If the Huo-Yan Laboratory ran at its full capacity, the number of suspected cases would decrease at least a week earlier, the peak of suspected cases would be reduced by at least 44% and the quarantine cost could be reduced by more than 72%. Ideally, if a daily testing capacity of 10,500 could achieved immediately after the Hubei lockdown, “daily settlement” for all suspected cases would be achieved immediately.

Conclusions

Large-scale and standardized clinical testing platform with nucleic acid testing, high-throughput sequencing and immunoprotein assessment capabilities need to be implemented simultaneously in order to maximize the effect of quarantine and minimize the duration and cost. Such infrastructure like Huo-Yan, is of great significance for the early prevention and control of infectious diseases for both common times and emergencies.
Mechanism of anterior cruciate ligament loading during dynamic motor tasks
Authors: Nasseri Azadeh , Lloyd David G , Bryant Adam L , Headrick Jonathon , Sayer Timothy , Saxby David J
Published: March 2020

This study determined anterior cruciate ligament (ACL) force and its contributors during a standardized drop-land-lateral jump task using a validated computational model. Healthy females (n=24) who were recreationally active performed drop-land-lateral jump and straight run tasks. Three-dimensional whole-body kinematics, ground reaction forces, and muscle activation patterns from eight lower limb muscles were collected concurrently during both tasks, but only the jump was analyzed computationally, with the run included for model calibration. External biomechanics, muscle-tendon unit kinematics, and muscle activation patterns were used to model lower limb muscle and ACL forces. Peak ACL force (2.3±0.5 BW) was observed at 13% of the stance phase during the drop-land-lateral jump task. The ACL force was primarily developed through the sagittal plane, and muscle was the dominant source of ACL loading. The gastrocnemii and quadriceps were main ACL antagonists (i.e., loaders), while hamstrings were the main ACL agonists (i.e., supporters).
Low variability of dynamical functional connectivity in cerebellar networks
Authors: Fernandez-Iriondo Izaro , Jimenez-Marin Antonio , Diez Ibai , Bonifazi Paolo , Swinnen Stephan P. , Muñoz Miguel A. , Cortes Jesus M.
Published: March 2020

Brain networks can be defined and explored using different types of connectivity. Here, we studied P=48 healthy participants with neuroimaging state-of-the-art techniques and analyzed the relationship between the actual structural connectivity (SC) networks (between 2514 regions of interest covering the entire brain and brainstem) and the dynamical functional connectivity (DFC) among the same regions. To do so, we focused on a combination of two metrics: the first one measures the degree of SC-DFC similarity –i.e. how much functional correlations can be explained by structural pathways– and the second one, the intrinsic variability of DFC networks across time. Overall, we found that cerebellar networks have smaller DFC variability than other networks in the cerebrum. Moreover, our results clearly evidence the internal structure of the cerebellum, which is divided in two differentiated networks, the posterior and anterior parts, the latter also being connected to the brain stem. The mechanism for keeping the DFC variability low in the posterior part of the cerebellum is consistent with another finding, namely, it exhibits the highest SC-DFC similarity among all other sub-networks, i.e. its structure constrains very strongly its dynamics. On the other hand, the anterior part of the cerebellum, which also exhibits a low level of DFC variability, has the lowest SC-DFC similarity, suggesting very different dynamical mechanisms. It is likely that its connections with the brain stem –which regulates sleep cycles, cardiac and respiratory functioning– might have a critical role in DFC variations in the anterior part. A lot is known about cerebellar networks, such as having extremely rich and complex anatomy and functionality, connecting to the brainstem, and cerebral hemispheres, and participating in a large variety of cognitive functions, such as movement control and coordination, executive function, visual-spatial cognition, language processing, and emotional regulation. However, as far as we know, our findings of low variability in the dynamical functional connectivity of cerebellar networks and its possible relation with the above functions, have not been reported so far. Further research is still needed to shed light on these findings.
A high-throughput genome-integrated assay reveals spatial dependencies governing Tcf7l2 binding
Authors: Szczesnik Tomasz , Chu Lendy , Ho Joshua W. K. , Sherwood Richard
Published: March 2020

2 Summary

Predicting where transcription factors bind in the genome from theirin-vitroDNA binding affinity is confounded by the large number of possible interactions with nearby transcription factors. To characterise the binding logic for the Wnt effector transcription factor Tcf7l2, we have developed a high-throughput screening platform in which thousands of 99-bp synthesised DNA sequences are inserted into a specific genomic locus through CRISPR/Cas9-based homology-directed repair, followed by measurement of Tcf7l2 binding by DamID. Using this platform at two genomic loci in mouse embryonic stem cells, we show that while the binding of Tcf7l2 closely follows thein-vitromotif binding strength and is influenced by local chromatin accessibility, it is also strongly affected by the surrounding 99-bp of sequence. The presence of nearby Oct4 and Klf4 motifs promote Tcf7l2 binding, particularly in the adjacent ~20 to 50-bp nearby and oscillating with a 10.8-bp phasing relative to these cofactor motifs, which matches the turn of a DNA helix. This novel high-throughput DamID assay provides a powerful platform to determine local DNA sequence grammars that causally influence transcription factor binding in controlled genomic contexts.
Prospects and limitations of expansion microscopy in chromatin ultrastructure determination
Authors: Kubalová Ivona , Černohorská Markéta Schmidt , Huranová Martina , Weisshart Klaus , Houben Andreas , Schubert Veit
Published: March 2020

Expansion Microscopy (ExM) is a method to magnify physically a specimen with preserved ultrastructure. It has the potential to explore structural features beyond the diffraction limit of light. The procedure has been successfully used for different animal species, from isolated macromolecular complexes through cells to tissue slices. Expansion of plant-derived samples is still at the beginning, and little is known whether the chromatin ultrastructure becomes altered by physical expansion.

In this study, we expanded isolated barley nuclei and compared whether ExM can provide a structural view of chromatin comparable with super-resolution microscopy. Different fixation and denaturation/digestion conditions were tested to maintain the chromatin ultrastructure. We achieved up to ∼4.2-times physically expanded nuclei corresponding to a maximal resolution of ∼50-60 nm when imaged by wild-field (WF) microscopy. By applying structured illumination microscopy (SIM, super-resolution) doubling the WF resolution the chromatin structures were observed at a resolution of ∼25-35 nm.

WF microscopy showed a preserved nucleus shape and nucleoli. Moreover, we were able to detect chromatin domains, invisible in unexpanded nuclei. However, by applying SIM we observed that the preservation of the chromatin ultrastructure after expansion was not complete and that the majority of the tested conditions failed to keep the ultrastructure.

Nevertheless, using expanded nuclei we detected successfully centromere repeats by fluorescencein situhybridization (FISH) and the centromere-specific histone H3 variant CENH3 by indirect immunostaining. However, although these repeats and proteins were localized at the correct position within the nuclei (indicating a Rabl orientation) their ultrastructural arrangement was impaired.