bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of thoracic kinesio taping on respiratory function and muscle strength in patients with chronic obstructive pulmonary disease
Authors: Zeng Renfeng , Tian Ke , Xiao Zhike
Published: April 2021

Background:

To our knowledge, only 1 study has investigated the effects of kinesio taping (KT) on pulmonary function and functional capacity of patients with chronic obstructive pulmonary disease (COPD). Therefore, there is still a lack of high-quality evidence to prove the effectiveness of KT for COPD patients. Our purpose was to investigate the effect of KT on respiratory function and muscle strength in the COPD patients who were in stable condition.

Methods:

This research project has been received ethical approval from the Medical Research and Ethics Committee in Affiliated Nanhua Hospital, University of South China. This work is a part of a comprehensive research project to assess and provide intervention that potentially improves respiratory function and quality of life among patients with COPD. Participants recruited into the study need to fulfill the following criteria: clinical diagnosis of COPD and symptoms indicative of exacerbation; spontaneous breathing on hospital admission; and physiotherapy since the first day of hospitalization. Patients will be assigned at random to the COPD medical treatment + KT (Group 1), or the COPD medical treatment alone (Group 2). The outcome measures are pulmonary function and respiratory muscle strength. The level of statistical significance is set as P < .05.

Results:

This protocol will provide a reliable theoretical basis for the following research.

Conclusions:

It was hypothesized that thoracic KT could significantly change pulmonary function and functional capacity in patients with COPD.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6632).
Association between programmed cell death ligand 1 expression and thyroid cancer
Authors: Wan Baoyu , Deng Pengyi , Dai Wenli , Wang Peng , Dong Zhizhi , Yang Chaojun , Tian Jinling , Hu Tao , Yan Kai
Published: April 2021

Background:

Programmed cell death ligand 1 (PD-L1), which is highly expressed in a variety of malignant tumors, is closely related to clinicopathological features and prognosis. However, there are few studies on the potential effects of PD-L1 on thyroid carcinoma, the incidence of which has shown an upward trend worldwide. This study aimed to explore the association between PD-L1 expression and clinicopathological features and prognosis of thyroid cancer.

Methods:

An elaborate retrieval was performed using Medline, PubMed, Cochrane Library, EMBASE, Web of Science, WanFang databases, and China National Knowledge Infrastructure to determine the association between PD-L1 expression and disease-free survival (DFS), overall survival (OS), and clinicopathological features in patients with thyroid cancer. Study selection, data extraction, risk assessment, and data synthesis were performed independently by 2 reviewers. In this meta-analysis, RevMan 5.3 and Stata 15.1 were used for bias risk assessment and data synthesis.

Results:

After a detailed search, 2546 cases reported in 13 articles were included in this meta-analysis. The outcomes revealed that high expression of PD-L1 in patients with thyroid cancer was associated with poor DFS (hazard ratio [HR] = 3.37, 95% confidence interval [CI] 2.54–4.48, P < .00001) and OS (HR = 2.52, 95% CI: 1.20–5.32, P = .01). High PD-L1 expression was associated with tumor size ≥2 cm, tumor recurrence, extrathyroidal extension, concurrent thyroiditis, unifocal tumor, and absence of psammoma body (P < .05). Subgroup analysis showed that positive expression of PD-L1 was related to poor prognosis for DFS of non-medullary thyroid carcinoma, and the overexpression of PD-L1 in differentiated thyroid carcinoma (DTC) was related to tumor recurrence, concurrent thyroiditis, extrathyroidal extension, unifocal DTC, late stage DTC, and BRAFV600E mutation in DTC.

Conclusion:

PD-L1 is a significant predictor of prognosis and malignancy of thyroid cancer (especially DTC), and PD-L1 inhibitors may be a promising therapeutic option for refractory thyroid cancer in the future.
Ultrasonographic features of eccrine spiradenoma
Authors: Xing Yuanyuan , Wu Xiaojing , Xu Caina , Sun Li , Li Huiying , Zhang Yafei , Xue Hongyuan , Ye Yuquan
Published: April 2021

Rationale:

Eccrine spiradenoma (ES) is a rare benign skin adnexal tumor originating from eccrine sweat glands. The features of ES on ultrasonography (US) have received little attention. Therefore, we report the sonographic findings in a case of an ES that originated from the abdominal wall and discuss the previously reported cases.

Patient concerns:

A 53-year-old woman was admitted to our hospital with a complaint of a painful nodule on the right side of her abdominal wall of 1-year duration.

Diagnoses:

The mass on the right side of abdominal wall was diagnosed as ES by histopathological examination.

Interventions:

The patient subsequently underwent total excision of the mass.

Outcomes:

The patient recovered well and had no complications during the 1-year follow-up.

Lessons:

As eccrine spiradenoma (ES) is rare and most of the tumors are excised without prior imaging studies. Little is known regarding the features of ES on ultrasonography (US). Familiarizing with the clinical and US features of this rare tumor may increase awareness of the disease among sonographers and clinicians.
Herbal medicine for the prevention of sarcopenia
Authors: Jeong Jin-Ho , Hwang Ji Hye
Published: April 2021

Background:

Sarcopenia is a syndrome characterized by a gradual and generalized loss of skeletal muscle mass and strength leading to physical disability, poor quality of life, and possible death. The disease impacts the steadily increasing aging population worldwide. In this systematic review protocol, we aim to investigate the effects and safety of herbal medicines on skeletal muscle health, specifically focusing on possible treatments for preventing sarcopenia.

Methods:

Nine electronic databases will be comprehensively searched from inception to the present date. Clinical studies reporting on the effects and safety of herbal medicines associated with skeletal muscle health and the prevention of sarcopenia will be included. The primary outcome will be determined by five categories: anti-inflammatory and antioxidant efficacy, muscle damage prevention, anti-fatigue effect, muscle-atrophy prevention, and muscle regeneration and differentiation. Two independent researchers will perform the research selection, data extraction, and quality assessment processes. The Cochrane risk-of-bias tool will be used to assess the methodological quality and design of the included studies. We will place no restrictions on publication status or language, and the results of the systematic review will be disseminated electronically and in print by publication in a peer-reviewed journal.

Results:

The present study will evaluate the effects and safety of herbal medicines for the prevention of sarcopenia.

Conclusion:

Our findings will provide guidance on the use of herbal medicines to prevent sarcopenia. This knowledge is valuable for elderly people, clinicians treating patients with sarcopenia, policy makers, and researchers.

Registration number:

Reviewregistry1113 (URL: https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/604a1e5ef176d2001b557750/).
Demographic Characteristics Driving Disparities in Receipt of Long-term Services and Supports in the Community Setting
Authors: Travers Jasmine L. , Naylor Mary D. , Coe Norma B. , Meng Can , Li Fangyong , Cohen Andrew B.
Published: April 2021

Background:

Research suggests that growth in Black and Hispanic (minority) older adults’ nursing home (NH) use may be the result of disparities in access to community-based and alternative long-term services and supports (LTSS).

Objective:

We aimed to determine whether minority groups receiving care in NHs versus the community had fewer differences in their functional needs compared with the differences in nonminority older adults, suggesting a disparity.

Methods:

We identified respondents aged 65 years or above with a diagnosis of Alzheimer disease or dementia in the 2016 Health and Retirement Study who reported requiring LTSS help. We performed unadjusted analyses to assess the difference in functional need between community and NH care. Functional need was operationalized using a functional limitations score and 6 individual activities of daily living. We compared the LTSS setting for minority older adults to White older adults using difference-in-differences.

Results:

There were 186 minority older adults (community=75%, NH=25%) and 357 White older adults (community=50%, NH=50%). Between settings, minority older adults did not differ in education or marital status, but were younger and had greater income in the NH versus the community. The functional limitations score was higher in NHs than in the community for both groups. Functional needs for all 6 activities of daily living for the minority group were greater in NHs compared with the community.

Conclusion:

Functional need for minority older adults differed by setting while demographics varied in unexpected ways. Factors such as familial and financial support are important to consider when implementing programs to keep older adults out of NHs.
Perceptions of Care Coordination Among Homeless Veterans Receiving Medical Care in the Veterans Health Administration and Community Care Settings
Authors: Jones Audrey L. , Gordon Adam J. , Gabrielian Sonya E. , Montgomery Ann Elizabeth , Blosnich John R. , Varley Allyson L. , deRussy Aerin J. , Austin Erika L. , Hoge April E. , Kim Young-il , Gelberg Lillian , Kertesz Stefan G.
Published: April 2021

Background:

Initiatives to expand Veterans’ access to purchased health care outside Veterans Health Administration (VHA) facilities (“community care”) present care coordination challenges for Veterans experiencing homelessness.

Objective:

Among Veterans with homeless experiences, to evaluate community care use and satisfaction, and compare perceptions of care coordination among Veterans using VHA services and community care to those using VHA services without community care.

Research Design:

Cross-sectional analysis of responses to a 2018 mailed survey.

Subjects:

VHA outpatients with homeless experiences.

Measures:

Self-reported use of community care, Likert-style ratings of satisfaction with that care, and Access/Coordination experiences from the Primary Care Quality-Homeless (PCQ-H) survey.

Results:

Of 4777 respondents, 1325 (26.7%) reported using community care; most of this subsample affirmed satisfaction with the community care they received (83%) and its timeliness (75%). After covariate adjustment, Veteran characteristics associated with greater community care use included female sex, being of retirement age and nonmarried, and having higher education, more financial hardship, ≥3 chronic conditions, psychological distress, depression, and posttraumatic stress disorder. Satisfaction with community care was lower among patients with travel barriers, psychological distress, and less social support. Compared with those using the VHA without community care, Veterans using VHA services and community care were more likely to report unfavorable access/coordination experiences [odds ratio (OR)=1.34, confidence interval (CI)=1.15–1.57]. This included hassles following referral (OR=1.37, CI=1.14–1.65) and perceived delays in receiving health care (OR=1.38, CI=1.19–1.61).

Conclusions:

Veterans with homeless experiences value community care options. Potential access benefits are balanced with risks of unfavorable coordination experiences for vulnerable Veterans with limited resources.
Comparison of Patient Experience Between Primary Care Settings Tailored for Homeless Clientele and Mainstream Care Settings
Authors: Kertesz Stefan G. , deRussy Aerin J. , Kim Young-il , Hoge April E. , Austin Erika L. , Gordon Adam J. , Gelberg Lillian , Gabrielian Sonya E. , Riggs Kevin R. , Blosnich John R. , Montgomery Ann E. , Holmes Sally K. , Varley Allyson L. , Pollio David E. , Gundlapalli Adi V. , Jones Audrey L.
Published: April 2021

Background:

More than 1 million Americans receive primary care from federal homeless health care programs yearly. Vulnerabilities that can make care challenging include pain, addiction, psychological distress, and a lack of shelter. Research on the effectiveness of tailoring services for this population is limited.

Objective:

The aim was to examine whether homeless-tailored primary care programs offer a superior patient experience compared with nontailored (“mainstream”) programs overall, and for highly vulnerable patients.

Research Design:

National patient survey comparing 26 US Department of Veterans Affairs (VA) Medical Centers’ homeless-tailored primary care (“H-PACT”s) to mainstream primary care (“mainstream PACT”s) at the same locations.

Participants:

A total of 5766 homeless-experienced veterans.

Measures:

Primary care experience on 4 scales: Patient-Clinician Relationship, Cooperation, Accessibility/Coordination, and Homeless-Specific Needs. Mean scores (range: 1–4) were calculated and dichotomized as unfavorable versus not. We counted key vulnerabilities (chronic pain, unsheltered homelessness, severe psychological distress, and history of overdose, 0–4), and categorized homeless-experienced veterans as having fewer (≤1) and more (≥2) vulnerabilities.

Results:

H-PACTs outscored mainstream PACTs on all scales (all P<0.001). Unfavorable care experiences were more common in mainstream PACTs compared with H-PACTs, with adjusted risk differences of 11.9% (95% CI=6.3–17.4), 12.6% (6.2–19.1), 11.7% (6.0–17.3), and 12.6% (6.2–19.1) for Relationship, Cooperation, Access/Coordination, and Homeless-Specific Needs, respectively. For the Relationship and Cooperation scales, H-PACTs were associated with a greater reduction in unfavorable experience for patients with ≥2 vulnerabilities versus ≤1 (interaction P<0.0001).

Conclusions:

Organizations that offer primary care for persons experiencing homelessness can improve the primary care experience by tailoring the design and delivery of services.
Case Series: Development of Polyps as a Late Effect After Total Body Irradiation-based Hematopoietic Cell Transplantation in Children With High-risk Leukemia
Authors: Knight Benjamin , Anderson Lynnette , Lerner Diana , Phelan Rachel , Thakar Monica S.
Published: April 2021

Advancements in hematopoietic cell transplantation (HCT) have led to increased survivorship rates in many childhood diseases. However, this growing group of long-term survivors face a myriad of late effects. There are currently limited guidelines for surveillance of gastrointestinal polyps for pediatric transplant patients. Here we describe 5 patients undergoing HCT with total body irradiation-based conditioning regimens for leukemia who developed symptomatic polyps a median of 4.5 (range: 0.75 to 5.75) years after HCT. Because of limited surveillance guidelines in children, we conclude that the development of new or progressive symptoms related to the gastrointestinal tract deserves prompt recognition and evaluation.
Successful Allogeneic Peripheral Blood Stem Cell Transplantation in 4 Wiskott-Aldrich Syndrome Patients
Authors: Benakli Malek , Ahmed Nacer Redhouane , Mehdid Farih , Rahmoune Nadia , Baazizi Mounira , Ait Ouali Dina , Bouarab Hanane , Zerkout Sara , Harieche Farida , Hamladji Rose-Marie
Published: April 2021

Background:

Allogeneic hematopoietic stem cell transplantation is a potential curative treatment in Wiskott-Aldrich syndrome (WAS). Here, we analyzed the outcomes in 4 WAS patients who underwent this procedure with peripheral blood stem cell (PBSC) in our center.

Patients and Methods:

Four patients with severe WAS phenotype have received allogeneic hematopoietic stem cell transplantation between January 2014 and December 2019 from matched sibling donors with PBSC. Two different preparative conditioning regimens were provided: the first associated busulfan-cyclophosphamide (2 patients) and the second with busulfan-fludarabine administered to the others. Cyclosporine gave as preferred graft-versus-host disease prophylaxis with a short course of methotrexate.

Results:

All patients achieved engraftment after PBSC with a median CD34+ cell count: 13.6×106/kg (8 to 24.9×106/kg). Chronic graft-versus-host disease developed in 2 patients treated by cyclosporine-steroids with complete resolution. Chimerism for all the patients was fully donor (>95% donor). After a median follow-up of 41 months (8 to 74 mo), all patients (100%) are alive, healthy, with complete clinical, immunologic, and hematologic recovery, without signs of WAS.

Conclusion:

This limited study with high-dose PBSC transplantation approach for WAS, demonstrated a safe and effective treatment option, with rapid engraftment, without complications, excellent long-term outcomes, independent of conditioning regimen.
Advanced Imaging and New Cardiac Biomarkers in Long-term Follow-up After Childhood Cancer
Authors: Sitte Vanessa , Burkhardt Barbara , Weber Roland , Kretschmar Oliver , Hersberger Martin , Bergsträsser Eva , Christmann Martin
Published: April 2021

Objectives:

Pathologic ejection fraction (EF), shortening fraction (FS), and standard heart failure biomarkers (high sensitive troponin T and N-terminal brain natriuretic peptide) during follow-up after childhood cancer have been associated with irreversible cardiac damage. We aimed to evaluate strain imaging values by echocardiography and new biomarkers for heart failure with preserved ejection fraction (HFpEF) as potential more sensitive parameters for cardiac deterioration in childhood cancer survivors (CCS).

Materials and Methods:

Prospective study with 50 CCS (median 16.2 y) at a median follow-up of 13 years. In addition to standard echo and laboratory parameters for heart failure, strain measurements and new biomarkers, including myocardial inflammation (interleukin 6), extracellular matrix (ECM) remodeling (C-telopeptide for type I collagen, intact N-terminal propeptide of type III procollagen), and other heart failure biomarkers (galectin 3, solutable ST2, growth differentiation factor 15), were obtained and compared with 50 healthy controls.

Results:

No significant differences in EF, FS, high sensitive troponin T, N-terminal brain natriuretic peptide, interleukin 6, solutable ST2, and galectin 3 were found between study and control groups. In contrast, strain imaging showed significant differences between both groups (global longitudinal strainGLS −16.1% vs. −20.4%, P<0.0001; global circumferential strain −14.3 vs. −21.4%, P<0.0001), detecting 66% (global longitudinal strain) and 76% (global circumferential strain) of patients with pathologic values in contrast to 6% (EF) and 16% (FS) for standard parameters. Markers for disturbances of ECM remodeling (C-telopeptide for type I collagen, intact N-terminal propeptide of type III procollagen, each P<0.0001) and growth differentiation factor 15 (P<0.0001) were significantly different between the groups.

Conclusion:

Strain imaging and new cardiac biomarkers used in HFpEF focusing on ECM remodeling appear to be more sensitive in detecting early remodeling processes in CCS than standard echo and laboratory parameters.
Steatotic and Steatohepatitic Hepatocellular Carcinomas
Authors: Aykutlu Umut , Argon Asuman , Orman Mehmet , Ulukaya Sezgin , Zeytunlu Murat , Karasu Zeki , Günşar Fulya , Nart Deniz , Akarca Ulus , Yilmaz Funda
Published: April 2021

Hepatocellular carcinomas (HCCs) with steatohepatitis and steatosis are reported with varying definitions and clinicopathologic features. We aimed to search the attributes of steatohepatitic hepatocellular carcinoma (SH-HCC) and steatotic-HCC in our series. A retrospective clinicopathologic analyses of 150 HCCs and immunostaining for C-reactive protein (CRP) and serum amyloid A (SAA) were performed. Tumors were reclassified as all SH-HCC, limited SH-HCC, typical SH-HCC (steatohepatitic features in >5%, 5% to 50%, and ≥50% of the tumor, respectively), steatotic-HCC, and classic HCC (C-HCC). Group comparisons were made using Kruskal-Wallis and Kaplan-Meier tests. The background etiology in all SH-HCCs was pure viral in 51.4%, nonalcoholic steatohepatitis (NASH)/alcoholic liver disease (ALD) alone/mixed in 34.3%, and unidentified in normal liver in 14.3%. All SH-HCCS (n=35, 23.3%) and typical SH-HCCs (n=13, 8.6%) had higher NASH/ALD. Limited SH-HCCs (n=22, 14.6%) had higher ALD (all P<0.05). Typical SH-HCCs tended to have more NASH (P=0.054). Steatotic-HCCs (n=13, 9%) and C-HCCs (n=102, 68%) had higher pure viral etiology and serum CRP (all P<0.05). CRP and SAA were positive in 69% and 27% of the tumors, respectively. SAA positivity correlated with ALD (P=0.026). In the overall group disease-free survival rates at 1, 5, 10, and 20 years were 97.0%, 82.3%, 79.6%, and 77.2%, respectively. Demographics, tumor characteristics, CRP and SAA positivity, and survival were similar between the groups (P>0.05). SH-HCC is heterogenous in terms of underlying etiologies, and can be seen in NASH/ALD, pure viral and noncirrhotic/normal background. The ≥50% cutoff for the definition of SH-HCC can lead to overlook ALD-related SH-HCC. Steatotic-HCC seems more similar to C-HCC rather than SH-HCC, but none of them feature as a different prognostic group.
Solitary Fibrous Tumors of the Pleura Shown on 18F-FDG and 68Ga-DOTA-FAPI-04 PET/CT
Authors: Zhang Annan , Zhang Huiyuan , Zhou Xin , Li Zhongwu , Li Nan
Published: April 2021

A 52-year-old man complained of pain in the right lower chest wall for a month. Chest CT found a subpleural mass, but failed to identify the nature of the tumor. The 18F-FDG PET/CT was conducted for further diagnosis and staging, which showed the mass in the lower lobe of the right lung with mild radioactive uptake of 18F-FDG. The patient was subsequently enrolled in an ongoing clinical trial using 68Ga-DOTA-FAPI-04 (fibroblast activation protein inhibitor) PET/CT. The mass showed intensive 68Ga-DOTA-FAPI-04 uptake, which was subsequently confirmed as solitary fibrous tumors of the pleura by pathology. Our case demonstrated that the 68Ga-DOTA-FAPI-04 might have excellent tumor affinity of solitary fibrous tumors of the pleura.
Academic Leadership
Authors: Esfahani Shadi A. , Subramaniam Rathan M.
Published: April 2021

Culture of inclusion is of utmost need in today’s practice of radiology and nuclear medicine. This article briefly describes the importance of establishing and enriching the culture of embracing different talents, perspectives, and expertise with consideration of differences in sex, ethnic, color, and socioeconomic background toward building high-performance research and clinical practice teams in academic nuclear medicine and radiology.
Patient Selection for Transoral Robotic Surgery (TORS) in Oropharyngeal Squamous Cell Carcinoma
Authors: Bunch Paul M. , Patwa Hafiz S. , Hughes Ryan T. , Porosnicu Mercedes , Waltonen Joshua D.
Published: April 2021

Transoral robotic surgery (TORS) is an excellent treatment strategy for well-selected patients with oropharyngeal squamous cell carcinoma. Potential benefits of TORS are greatest among patients for whom surgical resection will reduce or eliminate the need for adjuvant therapy. Proper patient selection largely depends on imaging, which is used to determine tumor resectability, to inform expected morbidity and functional outcome, to assess the potential need for adjuvant therapy, to evaluate for vascular or other anatomic contraindications, and to gauge adequacy of transoral access to the tumor. This article provides the radiologist with a practical and accessible approach to interpreting preoperative imaging among patients with oropharyngeal cancer, emphasizing what the surgeon wants to know to inform the determination of whether the patient is a TORS candidate and why this information is important. By accurately reporting this information, the radiologist facilitates the multidisciplinary care team's selection of a treatment regimen optimized for the circumstances of the individual patient.
Environmental and clinical isolates of Herbaspirillum induce pulmonary infection in mice and its secretome is cytotoxic to human lung cells
Authors: Olszewski Josyel , Weigert Galvão Carolina , Lipuma John J. , Paludo Katia Sabrina
Published: April 2021

Introduction. In recent years, the

Herbaspirillum

genus has emerged as a pathogen in healthcare-related infections and has became stablished as an opportunistic pathogen.

Hypothesis/Gap Statement. Little is known about the pathogenesis induced by

Herbaspirillum

genus.

Aim. To evaluate the cytotoxic effects of genus

Herbaspirillum

, its ability to adhere to lung human cells and the ability of environmental and clinical strains of

Herbaspirillum

to induce pneumonia in mice.

Methodology. Environmental and clinical isolates of

Herbaspirillum

were examined for their cytotoxic effects on the Calu-3 cell lineage. Cytotoxic activity of secretome was tested using MTT/neutral red assays and cell morphology analysis.

Herbaspirillum

adhesion on Calu-3 cells was assessed using bright-field microscopy and cell-associated bacteria were counted. A mouse model of acute lung infection was done using a clinical and an environmental strain. Adult male mice were used, and the pneumonia was inducted by intra-tracheal inoculation of 108 or 109 bacteria. Mice weight variations were evaluated at the end of the experiment. Bronchoalveolar lavage was collected and evaluated for total and differential cytology. A histological examination of lungs was performed giving a histological score.

Results. The secretomes of all the strains induced morphological alterations in cells, but only

H. seropedicae

SmR1 were cytotoxic in MTT and neutral red assays. Clinical strains of

H. frisingense

AU14459 and H. hutttiense subsp. huttiense AU11883 exhibited low adherence to lung cells, while SmR1 was non-adhesive. Following intratracheal inoculation, mice treated with 109 c.f.u. of the SmR1 and AU11883 strains lost 18 and 6% of their weight over 7 days, respectively, and presented moderate clinical signs. Infected mice showed inflammatory cell infiltration in the perivascular and peribroncheal/peribronchiolar spaces. Bronchoalveolar fluid of mice inoculated with SmR1 109 c.f.u. presented an increase in total leucocyte cells and in neutrophils population.

Conclusion. These in vivo and in vitro results provide insights into how some

Herbaspirillum

strains cause infection in humans, providing a basis for the characterization of pathogenesis studies on this emerging infectious agent.
New Zealand Emergency Department COVID-19 Preparedness Survey
Authors: Howard Michael J. , Chambers Charlotte , Mohr Nicholas M.
Published: April 2021

Objective

Our objective was to assess the level of COVID-19 preparedness of emergency departments (EDs) in Aotearoa New Zealand (NZ) through the views of emergency medicine specialists working in district health boards around the country. Given the limited experience NZ hospitals have had with SARS-CoV-2, a comparison of current local practice with recent literature from other countries identifying known weaknesses may help prevent future healthcare worker infections in NZ.

Methods

We conducted a cross-sectional survey of NZ emergency specialists in November 2020 to evaluate preparedness of engineering, administrative policy, and personal protective equipment (PPE) use.

Results

A total of 137 surveys were completed (32% response rate). More than 10% of emergency specialists surveyed reported no access to negative pressure rooms. N95 fit testing had not been performed in 15 (12%) of respondents. Most specialists (77%) work in EDs that cohort COVID-19 patients, about one-third (34%) do not use spotters during PPE doffing, and most (87%) do not have required space for physical distancing in non-patient areas. Initial PPE training, simulations and segregating patients were widespread but appear to be waning with persistent low SARS-CoV-2 prevalence. PPE shortages were not identified in NZ EDs, yet 13% of consultants do not plan to use respirators during aerosol generating procedures on COVID-19 patients. Available treatments including non-invasive ventilation and high-flow nasal cannula were common.

Conclusions

New Zealand emergency specialists identified significant gaps in COVID-19 preparedness, and they have a unique opportunity to translate lessons from other locations into local action. These data provide insight into weaknesses in hospital engineering, policy, and PPE practice in advance of future SARS-CoV-2 endemic transmission.

Strengths and limitations of this study

Survey responses specifically identified existing breakdowns in engineering, administrative policy and personal protective equipment in New Zealand emergency departments, potentially increasing healthcare worker nosocomial infection risk upon reintroduction of SARS-CoV-2

Survey included emergency specialists from all 20 of New Zealand’s district health boards but the electronic convenience sample may not be representative of all ED consultants in NZ

Some survey questions asked respondents to recall experiences or project how they would practice if they were caring for a COVID-19 patient and those motivated to respond may feel they have more or less access to protective policies and equipment than non-respondents
COVID-19 vaccine hesitancy among individuals with cancer, autoimmune diseases, and other serious comorbid conditions
Authors: Tsai Richard , Hervey John , Hoffman Kathleen D , Wood Jessica , Novack John , Johnson Jennifer , Deighton Dana C. , Loew Brian , Goldberg Stuart L
Published: April 2021

Background

Individuals with comorbid conditions have been disproportionately affected by COVID-19. Since regulatory clinical trials with COVID-19 vaccines excluded those with immunocompromising conditions, few patients with cancer and autoimmune diseases were enrolled. With limited vaccine safety data available, vulnerable populations may have conflicted vaccine attitudes.

Methods

To assess the incidence and reasons for COVID-19 vaccine hesitancy and to assess early vaccine safety, we conducted a cross-sectional online survey, fielded January 15, 2021 through February 22, 2021, with international participation (74% USA). A random sample of members of Inspire, an⍰online health⍰community⍰of over 2.2⍰million individuals⍰with comorbid conditions, completed a 55-item online survey.

Results

21,943 individuals completed the survey (100% with comorbidities including 27% cancer, 23% autoimmune diseases, 38% chronic lung diseases). 10% declared they would not, 4% stated they probably would not, and 5% were not sure they would agree to vaccination (hesitancy rate 19%). Factors associated with hesitancy included younger age, female gender, black-Pacific-Island-Native American heritage, less formal education, conservative political tendencies, resistance to masks or routine influenza vaccinations, and distrust of media coverage. 5501 (25%) had received at least one COVID-19 vaccine injection, including 29% of US participants. Following the first injection, 69% self-reported local and 40% systemic reactions, which increased following the second injection to 76% and 67%, respectively, with patterns mimicking clinical trials.

Conclusion

Nearly one in five individuals with serious comorbid conditions harbor COVID-19 hesitancy. Early safety experiences among those who have been vaccinated should be reassuring.

Highlights

Individuals with serious comorbid conditions, including cancer, have been disproportionately affected by COVID-19 and therefore have been prioritized for vaccination

An online survey of nearly 22,000 individuals with comorbid conditions revealed that nearly one in 5 expressed vaccine hesitancy.

Reasons for hesitancy in this comorbid population mimicked surveys of the general population.

Self-reported safety profiles among individuals with comorbid conditions were acceptable, and generally milder than reports in clinical trials among the general population.
Sex-specific metabolic pathways associate with Alzheimer’s Disease (AD) endophenotypes in the European Medical Information Framework for AD Multimodal Biomarker Discovery cohort
Authors: Xu Jin , Green Rebecca , Kim Min , Lord Jodie , Ebshiana Amera , Westwood Sarah , Baird Alison L , Nevado-Holgado Alejo J , Shi Liu , Hye Abdul , Snowden Stuart G. , Bos Isabelle , Vos Stephanie J. B. , Vandenberghe Rik , Teunissen Charlotte E. , Kate Mara Ten , Scheltens Philip , Gabel Silvy , Meersmans Karen , Blin Olivier , Richardson Jill , De Roeck Ellen Elisa , Engelborghs Sebastiaan , Sleegers Kristel , Bordet Régis , Rami Lorena , Kettunen Petronella , Tsolaki Magda , Verhey Frans R.J. , Alcolea Daniel , Lleó Alberto , Peyratout Gwendoline , Tainta Mikel , Johannsen Peter , Freund-Levi Yvonne , Frölich Lutz , Dobricic Valerija , Frisoni Giovanni B. , Molinuevo José Luis , Wallin Anders , Popp Julius , Martinez-Lage Pablo , Bertram Lars , Blennow Kaj , Zetterberg Henrik , Streffer Johannes , Visser Pieter Jelle , Lovestone Simon , Proitsi Petroula , Legido-Quigley Cristina
Published: April 2021

BACKGROUND

Physiological differences between males and females could contribute to the development of AD. Here, we examined metabolic pathways that may lead to precision medicine initiatives.

METHODS

We explored whether sex modifies the association of 540 plasma metabolites with AD endophenotypes including diagnosis, CSF biomarkers, brain imaging, and cognition using regression analyses for 695 participants (377 females), followed by sex-specific pathway overrepresentation analyses, APOE ε4 stratification and assessment of metabolites’ discriminatory performance in AD.

RESULTS

In females with AD, vanillylmandelate (tyrosine pathway) was increased and tryptophan betaine (tryptophan pathway) was decreased. The inclusion of these two metabolites (AUC = 0.83, SE = 0.029) to a baseline model (covariates + CSF biomarkers, AUC = 0.92, SE = 0.019) resulted in a significantly higher AUC of 0.96 (SE = 0.012). Kynurenate was decreased in males with AD (AUC = 0.679, SE = 0.046).

CONCLUSIONS

Metabolic sex-specific differences were reported, covering neurotransmission and inflammation pathways with AD endophenotypes. Two metabolites, in pathways related to dopamine and serotonin, associated to females, paving the way to personalised treatment.
Examining Recent Trends in the Racial Disparity Gap in Tap Water Consumption: NHANES 2011–2018
Authors: Rosinger Asher Y. , Patel Anisha I. , Weaks Francesca
Published: April 2021

Objective

As tap water distrust has grown in the US with greater levels among Black and Hispanic households, we aimed to examine recent trends in not drinking tap water including the period covering the US Flint Water Crisis and racial/ethnic disparities in these trends.

Design, Setting, and Participants

We analyzed data from the cross-sectional National Health and Nutrition Examination Survey data (2011–2018) for 9,439 children aged 2-19 and 17,268 adults. Log-binomial regressions and marginal predicted probabilities examined US nationally-representative trends in tap and bottled water consumption overall and by race/ethnicity.

Results

Among US children and adults, respectively, in 2017-2018 there was a 63% (adjusted prevalence ratio [PR]:1.63, 95%CI: 1.25-2.12, p<0.001) and 40% (PR:1.40, 95%CI: 1.16-1.69, p=0.001) higher prevalence of not drinking tap water compared to 2013-2014 (pre-Flint Water Crisis). For Black children and adults, the probability of not drinking tap water increased significantly from 18.1% (95%CI: 13.4-22.8) and 24.6% (95%CI: 20.7-28.4) in 2013–14 to 29.3% (95%CI: 23.5-35.1) and 34.5% (95%CI: 29.4-39.6) in 2017–2018. Among Hispanic children and adults, not drinking tap water increased significantly from 24.5% (95%CI: 19.4-29.6) and 27.1% (95%CI: 23.0-31.2) in 2013-14 to 39.7% (95%CI: 32.7-46.8) and 38.1% (95%CI: 33.0-43.1) in 2017-2018. No significant increases were observed among Asian or white persons between 2013-14 and 2017-18. Similar trends were found in bottled water consumption.

Conclusions

This study found persistent disparities in the tap water consumption gap from 2011–2018. Black and Hispanics’ probability of not drinking tap water increased following the Flint Water Crisis.
plantR: An R package and workflow for managing species records from biological collections
Authors: de Lima Renato A. F. , Sánchez-Tapia Andrea , Mortara Sara R. , Steege Hans ter , de Siqueira Marinez F.
Published: April 2021

Species records from biological collections are becoming increasingly available online. This unprecedented availability of records has largely supported recent studies in taxonomy, biogeography, macroecology, and biodiversity conservation. Biological collections vary in their documentation and notation standards, which have changed through time. For different reasons, neither collections nor data repositories perform the editing, formatting, and standardization of the data, leaving these tasks to the final users of the species records (e.g. taxonomists, ecologists and conservationists). These tasks are challenging, particularly when working with millions of records from hundreds of biological collections.

To help collection curators and final users perform those tasks, we introduceplantR, an open-source package that provides a comprehensive tool-box to manage species records from biological collections. The package is accompanied by the proposal of a reproducible workflow to manage this type of data in taxonomy, ecology, and biodiversity conservation. It is implemented inRand designed to handle relatively large data sets as fast as possible. Initially designed to handle plant species records, many of theplantRfeatures also apply to other groups of organisms, given that the data structure is similar.

TheplantRworkflow includes tools to (1) download records from different data repositories, (2) standardize typical fields associated with species records, (3) validate the locality, geographical coordinates, taxonomic nomenclature, and species identifications, including the retrieval of duplicates across collections, and (4) summarize and export records, including the construction of species checklists with vouchers.

OtherRpackages provide tools to tackle some of the workflow steps described above. But in addition to the new features and resources related to the data editing and validation, the greatest strength ofplantRis to provide a comprehensive and user-friendly workflow in one single environment, performing all tasks from data retrieval to export. Thus,plantRcan help researchers better assess data quality and avoid data leakage in a wide variety of studies using species records.
Juvenile emperor penguin range calls for extended conservation measures in the Southern Ocean
Authors: Houstin Aymeric , Zitterbart Daniel P. , Heerah Karine , Eisen Olaf , Planas-Bielsa Víctor , Fabry Ben , Bohec Céline Le
Published: April 2021

To protect the unique Southern Ocean biodiversity, conservation measures like marine protected areas (MPAs) are implemented based on the known habitat distribution of ecologically important species. However, distribution models focus on adults, neglecting that immatures animals can inhabit vastly different areas. Here, we show that current conservation efforts in the Southern Ocean are insufficient for ensuring the protection of the highly mobile Emperor penguin. We find that juveniles spend ∼90% of their time outside the boundaries of proposed and existing MPAs, and that their distribution extends far beyond (> 1500 km) the species’ extent of occurrence as defined by the International Union for Conservation of Nature. We argue that strategic conservation plans for Emperor penguin and long-lived ecologically important species must consider the dynamic habitat range of all age classes.
Online single-cell data integration through projecting heterogeneous datasets into a common cell-embedding space
Authors: Xiong Lei , Tian Kang , Li Yuzhe , Zhang Qiangfeng Cliff
Published: April 2021

Computational tools for integrative analyses of diverse single-cell experiments are facing formidable new challenges including dramatic increases in data scale, sample heterogeneity, and the need to informatively cross-reference new data with foundational datasets. Here, we present SCALEX, a deep-learning method that integrates single-cell data by projecting cells into a batch-invariant, common cell-embedding space in a truly online manner (i.e., without retraining the model). SCALEX substantially outperforms online iNMF and other state-of-the-art non-online integration methods on benchmark single-cell datasets of diverse modalities, (e.g., scRNA-seq, scATAC-seq), especially for datasets with partial overlaps, accurately aligning similar cell populations while retaining true biological differences. We showcase SCALEX’s advantages by constructing continuously expandable single-cell atlases for human, mouse, and COVID-19 patients, each assembled from diverse data sources and growing with every new data. The online data integration capacity and superior performance makes SCALEX particularly appropriate for large-scale single-cell applications to build-upon previously hard-won scientific insights.
Fungal community turnover along steep environmental gradients from geothermal soils in Yellowstone National Park
Authors: Bazzicalupo Anna L. , Erlandson Sonya , Branine Margaret , Ratz Megan , Ruffing Lauren , Nguyen Nhu H. , Branco Sara
Published: April 2021

Geothermal soils offer unique insight into the way extreme environmental factors shape communities of organisms. However, little is known about the fungi growing in these environments and in particular how localized steep abiotic gradients affect fungal diversity. We used metabarcoding to characterize soil fungi surrounding a hot spring-fed thermal creek with water up to 84 °C and pH 10 in Yellowstone National Park. We found a significant association between fungal communities and soil variable principal components, and we identify the key trends in co-varying soil variables that explain the variation in fungal community. Saprotrophic and ectomycorrhizal fungi community profiles followed, and were significantly associated with, different soil variable principal components, highlighting potential differences in the factors that structure these different fungal trophic guilds. In addition,in vitrogrowth experiments in four target fungal species revealed a wide range of tolerances to pH levels but not to heat. Overall, our results documenting turnover in fungal species within a few hundred meters suggest many co-varying environmental factors structure the diverse fungal communities found in the soils of Yellowstone National Park.
Altered drug metabolism and increased susceptibility to fatty liver disease in myotonic dystrophy
Authors: Dewald Zac , Gupta Andrew , Chembazhi Ullas V. , Kalsotra Auinash
Published: April 2021

Myotonic Dystrophy type 1 (DM1), a prevalent muscular dystrophy affecting 1 in 2800 individuals, is associated with a toxic (CTG)nrepeat expansion in theDMPKgene. While DM1 affects multiple systems, recent studies highlight its link to liver pathology, glucose intolerance, and drug sensitivity. Our study focused on liver implications by creating a hepatocyte-specific DM1 mouse model. Expression of toxic RNA in hepatocytes sequestered muscleblind-like (MBNL) proteins, impacting hepatocellular activity. DM1-induced liver alterations included morphological changes, inflammation, necrosis, and fatty accumulation. Impaired drug metabolism and clearance were evident in DM1 mice and increased susceptibility to diet-induced fatty liver disease. Notably, alternative splicing of acetyl-CoA carboxylase 1 induced excessive lipid accumulation in DM1 livers, exacerbated by high-fat, high-sugar diets. These findings unveil disruptions in hepatic functions, predisposing DM1 livers to injury, fatty liver disease, and compromised drug clearance. Understanding these mechanisms is crucial for addressing the complex health challenges in DM1 patients and optimizing treatment strategies.
Sustained Oxygenation Accelerates Diabetic Wound Healing by Simultaneously Promoting Epithelialization and Angiogenesis, and Decreasing Tissue Inflammation
Authors: Guan Ya , Niu Hong , Liu Zhongting , Dang Yu , Shen Jie , Zayed Mohamed , Ma Liang , Guan Jianjun
Published: April 2021

Non-healing diabetic wound is one of the most common complications for diabetic patients. Chronic hypoxia is among the prominent factors that delay the wound healing process. Therefore, sustained oxygenation to alleviate hypoxia is hypothesized to promote diabetic wound healing. Yet it cannot be achieved by current clinical approaches including hyperbaric oxygen therapy. Herein, we developed a sustained oxygenation system consisting of oxygen-release microspheres and a reactive oxygen species (ROS)-scavenging hydrogel. The hydrogel was used to capture the ROS that is elevated in the diabetic wounds, and that may be generated due to oxygen release. The sustainedly released oxygen augmented survival and migration of keratinocytes and dermal fibroblasts; promoted angiogenic growth factor expression, and angiogenesis in the diabetic wounds; and decreased M1 macrophage density. These effects led to a significant increase of wound closure rate. These findings reveal that sustained oxygenation alone without using drugs is capable of healing diabetic wounds.
Activity-dependent Golgi satellite formation in dendrites reshapes the neuronal surface glycoproteome
Authors: Govind Anitha P. , Jeyifous Okunola , Russell Theron A. , Yi Zola , Weigel Aubrey V. , Ramaprasad Abhijit , Newell Luke , Ramos William , Valbuena Fernando M. , Casler Jason C. , Yan Jing-Zhi , Glick Benjamin S. , Swanson Geoffrey T. , Lippincott-Schwartz Jennifer , Green William N.
Published: April 2021

Activity-driven changes in the neuronal surface glycoproteome are known to occur with synapse formation, plasticity and related diseases, but their mechanistic basis and significance are unclear. Here, we observed thatN-glycans on surface glycoproteins of dendrites shift from immature to mature forms containing sialic acid in response to increased neuronal excitation. In exploring the basis of theseN-glycosylation alterations, we discovered they result from the growth and proliferation of Golgi satellites scattered throughout the dendrite. Golgi satellites that formed with neuronal excitation were in close association with ER exit sites and early endosomes and contained glycosylation machinery without the Golgi structural protein, GM130. They functioned as distal glycosylation stations in dendrites, terminally modifying sugars either on newly synthesized glycoproteins passing through the secretory pathway, or on surface glycoproteins taken up from the endocytic pathway. These activities led to major changes in the dendritic surface of excited neurons, impacting binding and uptake of lectins, as well as causing functional changes in neurotransmitter receptors such as nicotinic acetylcholine receptors. Neural activity thus boosts the activity of the dendrite’s satellite micro-secretory system by redistributing Golgi enzymes involved in glycan modifications into peripheral Golgi satellites. This remodeling of the neuronal surface has potential significance for synaptic plasticity, addiction and disease.