bluuebunny/crossref_metadata_2025 huggingface dataset:
Routine pre-employment echocardiography assessment in young adults: cost and benefits
Authors: Gaafar Ahmed , Gaafar Asmaa
Published: January 2021

Background

Conventional echocardiography is a safe, available, and accurate tool for cardiac structural and functional evaluation, but it should not cancel clinical assessment and history tacking, and indeed both are complementary. A pre-employment assessment is important for employees and community safety and suitability for a specific work requirement.

Results

Aiming to assess the value of routine pre-employment echocardiography for the detection of cardiac abnormalities, we examined seven hundred ninety-five persons who were routinely referred to us for pre-employment conventional echocardiography. Only 9 persons had structural cardiac abnormalities (1.3%) and distributed as follows: two had bicuspid aortic valve with isolated aortic regurgitation, one of them had mild AR, and the other had moderate AR. Two cases had mitral valve prolapse, one of them had trivial MR, while the other had a flail anterior leaflet with severe MR. One patient had atrial septal defect 1.5 cm with mild pulmonary hypertension and right-sided chambers dilatation. One patient had dextrocardia (situs inversus totalis) without other cardiac problems. One had moderate pulmonary hypertension and modest right-sided chambers dilation. Two patients had left ventricular hypertrophy. Surprisingly, we did not detect rheumatic valvular heart disease. The money cost of echocardiography tests for those 795 persons was 198,750 Egyptian pounds (LE); their transportation cost was about 19.800LE. The total group time cost of the tests was 265 h, total time lost at the waiting room was 1590 h, total transportation time lose was 2385 h, so the total time cost was about 4000 h. Using psychological stress questionnaire, 33 participants (4.2%) had results suggestive of a low sense of psychological pressure due to echocardiography examination, 221 participants (27.8%) had results suggestive of a moderate feeling of stress, while 541 participants (68%) had results suggestive of a high sense of stress.

Conclusion

We recommend against routine echocardiography for cardiac assessment in pre-employment assessment and to do it only for persons with abnormal clinical or ECG findings.
Imaging features associated with survival outcomes among colorectal cancer patients with and without KRAS mutation
Authors: Promsorn Julaluck , Chadbunchachai Payia , Somsap Kulyada , Paonariang Krisada , Sa-ngaimwibool Prakasit , Apivatanasiri Chaiwat , Lahoud Rita Maria , Harisinghani Mukesh
Published: January 2021

Background

Mutations in Kirsten rat sarcoma proto-oncogene (KRAS) have been shown to be associated with advanced-stage colorectal cancer (CRC), negative disease outcomes, and poor response to treatment. The purpose of this study was to investigate which CT features are biomarkers for KRAS gene mutation and impact the survival outcomes of colorectal cancer patients.

Results

Of the 113 CRC patients included in the study, 46 had KRAS mutations (40.71%) and 67 had no mutations (59.29%). Regional lymph node necrosis was the only imaging feature significantly associated with KRAS mutation (P = 0.011). Higher T staging and liver, lung, and distant metastasis were prognostic factors for CRC (P = 0.014, P < 0.001, P = 0.022, P < 0.001, respectively). There were no significant differences in overall survival between patients with KRAS mutations and those without (P = 0.159). However, in patients with no KRAS mutation, those with CRC on the left side had a significantly higher rate of survival than those with CRC on the right (P = 0.005).

Conclusion

Regional lymph node necrosis may be an imaging biomarker of CRC with KRAS mutation, possibly indicating poor prognosis.
Optimal reactive power dispatch: a bibliometric analysis
Authors: Shanono Ibrahim Haruna , Muhammad Aisha , Abdullah Nor Rul Hasma , Daniyal Hamdan , Tiong Meng Chung
Published: January 2021

Optimal reactive power dispatch (ORPD) plays a significant role in the control and smooth operation of the power system through the enhancement of the network’s reliability, security, and economic aspects. This paper presents a bibliometric and visual analysis of ORPD-related research articles extracted from the Web of Science (WoS) database from its inception to October 29, 2019. A total of 263 articles drawn from 166 journals, published between 1989 and 2019, were retrieved and analysed using Excel, HistCite, and VOSviewer visualisation software. The total number of citations for the 263 articles ranges from 0 to 297. The top three journals with the most significant number of ORPD publications were the International Journal of Electrical Power and Energy Systems, Applied Soft Computing, and two journals qualified for the third place, IEEE Transaction on Power Systems and IET Generation Transmission and Distribution. The most active researcher is Provas Kumar Roy, with nine (9) articles from Kalyani Government Engineering College. The most trending/cited researcher is Yi Jia Cao, with 129 Total Local Citation Scores from Hunan University, Changsha. In terms of contribution by countries, India, China, Iran, and the United States were the most significant contributors with 27.8%, 20.9%, 11.8%, and 8% of the total articles, respectively. The top 5 most frequently used substantive keywords to identify the trending topic and research direction were Particle Swarm Optimisation, Genetic Algorithm, Gravitational Search Algorithm, Linear Programming, Evolutional Algorithm, and Hybrid Algorithm. This study provides a detailed outline and reveals the future research directions for both experienced and novice ORPD researchers to identify research topics, questions, and collaboration partners.
Three-dimensional fatigue crack propagation analysis of welded steel beam based on global-local numerical model
Authors: Zong Liang , Shi Gang
Published: January 2021

The existing fatigue assessment approaches were mainly conducted on the component level. The interaction of local component damage and the global response cannot be well addressed. In this study, three-dimensional (3D) fatigue crack propagation analysis approach based on global-local numerical model was implemented, and examined to be accurate and effective through a series of systematic experimental data obtained by Fisher. Afterwards, the approach was introduced into a typical steel truss bridge for realizing more refined fatigue assessment from the global structural level. The fatigue performance of the longitudinal steel welded beam in the steel truss bridge was investigated based on global-local model and local model respectively. It was found that there is no difference in terms of the fatigue crack growth mechanism between the simulation between global-local model and local model due to that the stress level of the whole structure is relatively low. At last, the effect of heavy haul train operation on the fatigue performance of the steel truss bridge was analyzed. It was observed that the residual life of the longitudinal steel welded beam would have an obvious reduction when the axle load was increasing. The research work in this study presents a technical solution for the fatigue assessment of the global structure and can provide beneficial reference for relevant practical engineering projects.
Impact of Community-Based Clinical Breast Examinations in Botswana
Authors: Dykstra Michael , Malone Brighid , Lekuntwane Onica , Efstathiou Jason , Letsatsi Virginia , Elmore Shekinah , Castro Cesar , Tapela Neo , Dryden-Peterson Scott
Published: January 2021

PURPOSE

We evaluated a clinical breast examination (CBE) screening program to determine the prevalence of breast abnormalities, number examined per cancer diagnosis, and clinical resources required for these diagnoses in a middle-income African setting.

METHODS

We performed a retrospective review of a CBE screening program (2015-2018) by Journey of Hope Botswana, a Botswana-based nongovernmental organization (NGO). Symptomatic and asymptomatic women were invited to attend. Screening events were held in communities throughout rural and periurban Botswana, with CBEs performed by volunteer nurses. Individuals who screened positive were referred to a private tertiary facility and were followed by the NGO. Data were obtained from NGO records.

RESULTS

Of 6,120 screened women (50 men excluded), 452 (7.4%) presented with a symptom and 357 (5.83%) were referred for further evaluation; 257 ultrasounds, 100 fine-needle aspirations (FNAs), 58 mammograms, and 31 biopsies were performed. In total, 6,031 were exonerated from cancer, 78 were lost to follow-up (67 for ≤ 50 years and 11 for > 50 years), and 11 were diagnosed with cancer (five for 41-50 years and six for > 50 years, 10 presented with symptoms). Overall breast cancer prevalence was calculated to be 18/10,000 (95% CI, 8 to 29/10,000). The number of women examined per breast cancer diagnosis was 237 (95% CI, 126 to 1910) for women of age 41-50 years and 196 (95% CI, 109 to 977) for women of age > 50 years. Median time to diagnosis for all women was 17.5 [1 to 32.5] days. CBE-detected tumors were not different than tumors presenting through standard care.

CONCLUSION

In a previously unscreened population, yield from community-based CBE screening was high, particularly among symptomatic women, and required modest diagnostic resources. This strategy has potential to reduce breast cancer mortality.
Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA): A Multicenter Randomized Clinical Trial
Authors: van der Veen Arjen , Brenkman Hylke J. F. , Seesing Maarten F. J. , Haverkamp Leonie , Luyer Misha D. P. , Nieuwenhuijzen Grard A. P. , Stoot Jan H. M. B. , Tegels Juul J. W. , Wijnhoven Bas P. L. , Lagarde Sjoerd M. , de Steur Wobbe O. , Hartgrink Henk H. , Kouwenhoven Ewout A. , Wassenaar Eelco B. , Draaisma Werner A. , Gisbertz Suzanne S. , van der Peet Donald L. , May Anne M. , Ruurda Jelle P. , van Hillegersberg Richard ,   LOGICA Study Group, Eligh Anne M. , Ponten Jeroen E. H. , Heesakkers Fanny F. B. M. , Hulsewe Karel W. E. , Tweed Thais T. T. , van Lanschot Jan J. B. , van Det Marc J. , van Duijvendijk P. , van der Zaag Edwin S. , Broeders Ivo A. M. J. , van Berge Henegouwen Mark I. , Eshuis Wietse J. , Daams Freek , Heineman David J. , van Laarhoven Hanneke W. M.
Published: January 2021

BACKGROUND

The oncological efficacy and safety of laparoscopic gastrectomy are under debate for the Western population with predominantly advanced gastric cancer undergoing multimodality treatment.

METHODS

In 10 experienced upper GI centers in the Netherlands, patients with resectable (cT1-4aN0-3bM0) gastric adenocarcinoma were randomly assigned to either laparoscopic or open gastrectomy. No masking was performed. The primary outcome was hospital stay. Analyses were performed by intention to treat. It was hypothesized that laparoscopic gastrectomy leads to shorter hospital stay, less postoperative complications, and equal oncological outcomes.

RESULTS

Between 2015 and 2018, a total of 227 patients were randomly assigned to laparoscopic (n = 115) or open gastrectomy (n = 112). Preoperative chemotherapy was administered to 77 patients (67%) in the laparoscopic group and 87 patients (78%) in the open group. Median hospital stay was 7 days (interquartile range, 5-9) in both groups ( P = .34). Median blood loss was less in the laparoscopic group (150 v 300 mL, P < .001), whereas mean operating time was longer (216 v 182 minutes, P < .001). Both groups did not differ regarding postoperative complications (44% v 42%, P = .91), in-hospital mortality (4% v 7%, P = .40), 30-day readmission rate (9.6% v 9.1%, P = 1.00), R0 resection rate (95% v 95%, P = 1.00), median lymph node yield (29 v 29 nodes, P = .49), 1-year overall survival (76% v 78%, P = .74), and global health-related quality of life up to 1 year postoperatively (mean differences between + 1.5 and + 3.6 on a 1-100 scale; 95% CIs include zero).

CONCLUSION

Laparoscopic gastrectomy did not lead to a shorter hospital stay in this Western multicenter randomized trial of patients with predominantly advanced gastric cancer. Postoperative complications and oncological efficacy did not differ between laparoscopic gastrectomy and open gastrectomy.
Clinical Implications of Minimal Residual Disease Detection in Infants With KMT2A-Rearranged Acute Lymphoblastic Leukemia Treated on the Interfant-06 Protocol
Authors: Stutterheim Janine , van der Sluis Inge M. , de Lorenzo Paola , Alten Julia , Ancliffe Philip , Attarbaschi Andishe , Brethon Benoit , Biondi Andrea , Campbell Myriam , Cazzaniga Giovanni , Escherich Gabriele , Ferster Alina , Kotecha Rishi S. , Lausen Birgitte , Li Chi Kong , Lo Nigro Luca , Locatelli Franco , Marschalek Rolf , Meyer Claus , Schrappe Martin , Stary Jan , Vora Ajay , Zuna Jan , van der Velden Vincent H. J. , Szczepanski Tomasz , Valsecchi Maria Grazia , Pieters Rob
Published: January 2021

PURPOSE

Infant acute lymphoblastic leukemia (ALL) is characterized by a high incidence of KMT2A gene rearrangements and poor outcome. We evaluated the value of minimal residual disease (MRD) in infants with KMT2A-rearranged ALL treated within the Interfant-06 protocol, which compared lymphoid-style consolidation (protocol IB) versus myeloid-style consolidation (araC, daunorubicin, etoposide/mitoxantrone, araC, etoposide).

MATERIALS AND METHODS

MRD was measured in 249 infants by DNA-based polymerase chain reaction of rearranged KMT2A, immunoglobulin, and/or T-cell receptor genes, at the end of induction (EOI) and end of consolidation (EOC). MRD results were classified as negative, intermediate (< 5 × 10−4), and high (≥ 5 × 10−4).

RESULTS

EOI MRD levels predicted outcome with 6-year disease-free survival (DFS) of 60.2% (95% CI, 43.2 to 73.6), 45.0% (95% CI, 28.3 to 53.1), and 33.8% (95% CI, 23.8 to 44.1) for infants with negative, intermediate, and high EOI MRD levels, respectively ( P = .0039). EOC MRD levels were also predictive of outcome, with 6-year DFS of 68.2% (95% CI, 55.2 to 78.1), 40.1% (95% CI, 28.1 to 51.9), and 11.9% (95% CI, 2.6 to 29.1) for infants with negative, intermediate, and high EOC MRD levels, respectively ( P < .0001). Analysis of EOI MRD according to the type of consolidation treatment showed that infants treated with lymphoid-style consolidation had 6-year DFS of 78.2% (95% CI, 51.4 to 91.3), 47.2% (95% CI, 33.0 to 60.1), and 23.2% (95% CI, 12.1 to 36.4) for negative, intermediate, and high MRD levels, respectively ( P < .0001), while for myeloid-style–treated patients the corresponding figures were 45.0% (95% CI, 23.9 to 64.1), 41.3% (95% CI, 23.2 to 58.5), and 45.9% (95% CI, 29.4 to 60.9).

CONCLUSION

This study provides support for the idea that induction therapy selects patients for subsequent therapy; infants with high EOI MRD may benefit from AML-like consolidation (DFS 45.9% v 23.2%), whereas patients with low EOI MRD may benefit from ALL-like consolidation (DFS 78.2% v 45.0%). Patients with positive EOC MRD had dismal outcomes. These findings will be used for treatment interventions in the next Interfant protocol.
Leadership in a crisis: doing things differently, doing different things
Authors: Paixão Graça , Mills Chloe , McKimm Judy , Hassanien Mohammed A , Al-Hayani Abdulmonem A
Published: January 2021

This article summarises the findings from a review of publications related to healthcare leadership that were published during the first wave of the COVID-19 crisis in 2020. The review discusses a range of strategies for leaders to adopt in challenging situations and identifies three aspects of leadership which are considered essential when leading teams during a crisis: 1) communication, 2) decision making and 3) mental health and wellbeing. This article identifies key principles for each of these three aspects and provides practical tips for how leaders can use the lessons learned from the pandemic in their own contexts.
Classical characterization of quantum waves: comparison between the caustic and the zeros of the Madelung–Bohm potential
Authors: Espíndola-Ramos Ernesto , Silva-Ortigoza Gilberto , Sosa-Sánchez Citlalli Teresa , Julián-Macías Israel , González-Juárez Adriana , Cabrera-Rosas Omar de Jesús , Ortega-Vidals Paula , Rickenstorff-Parrao Carolina , Silva-Ortigoza Ramón
Published: January 2021

From a geometric perspective, the caustic is the most classical description of a wave function since its evolution is governed by the Hamilton–Jacobi equation. On the other hand, according to the Madelung–de Broglie–Bohm equations, the most classical description of a solution to the Schrödinger equation is given by the zeros of the Madelung–Bohm potential. In this work, we compare these descriptions, and, by analyzing how the rays are organized over the caustic, we find that the wave functions with fold caustic are the most classical beams because the zeros of the Madelung–Bohm potential coincide with the caustic. For another type of beam, the Madelung–Bohm potential is in general distinct to zero over the caustic. We have verified these results for the one-dimensional Airy and Pearcey beams, which, according to the catastrophe theory, have stable caustics. Similarly, we introduce the optical Madelung–Bohm potential, and we show that if the optical beam has a caustic of the fold type, then its zeros coincide with the caustic. We have verified this fact for the Bessel beams of nonzero order. Finally, we remark that for certain cases, the zeros of the Madelung–Bohm potential are linked with the superoscillation phenomenon.
Single-layered meta-reflectarray for polarization retention and spin-encrypted phase-encoding
Authors: Khaliq Hafiz Saad , Akram Muhammad Rizwan , Riaz Kashif , Ansari Muhammad Afnan , Akbar Jehan , Zhang Jin , Zhu Weiren , Zhang Dajun , Wang Xiong , Zubair Muhammad , Mehmood Muhammad Qasim
Published: January 2021

Broadband communication with high data rates is a dire need for state-of-the-art wireless technologies. For achieving efficient wireless communication (particularly in an indoor environment), the electromagnetic (EM) waves should maintain their state of polarization despite encountering multiple reflections. Metasurfaces provide a unique platform to design subwavelength-featured meta-reflectarrays which enable the desired retention of the polarization state of an EM wave upon reflection. We present a single-layered broadband meta-reflectarray, simultaneously breaking n-fold (n > 2) rotational and mirror symmetry, which exhibits an unprecedented control over the phase, amplitude, and polarization of a reflected EM wave. This unique control enables the retention of polarization state and recording of spin-encrypted information for the reflected EM waves. Such novel multifunctional meta-reflectarray can be crucial to building an indoor setup for high data rate wireless communications. Meanwhile, the meta-array’s ability to encode phase information provides an extra degree of freedom to structure and control (via incident spin) the reflected EM beam in the desired way. For the proof of concept, we have experimentally demonstrated a spin-encrypted holographic display which reconstructs the recorded holographic image at an image plane for the left circularly polarized (LCP) illumination and exhibits circular dichroism for the right circularly polarized (RCP) incident waves. The proposed meta-array can find applications in 5G indoor wireless communication, chiral sensing, spin-selective imaging, holography, and encryption.
Sampling bias and model choice in continuous phylogeography: Getting lost on a random walk
Authors: Kalkauskas Antanas , Perron Umberto , Sun Yuxuan , Goldman Nick , Baele Guy , Guindon Stephane , De Maio Nicola
Published: January 2021

Phylogeographic inference allows reconstruction of past geographical spread of pathogens or living organisms by integrating genetic and geographic data. A popular model in continuous phylogeography—with location data provided in the form of latitude and longitude coordinates—describes spread as a Brownian motion (Brownian Motion Phylogeography, BMP) in continuous space and time, akin to similar models of continuous trait evolution. Here, we show that reconstructions using this model can be strongly affected by sampling biases, such as the lack of sampling from certain areas. As an attempt to reduce the effects of sampling bias on BMP, we consider the addition of sequence-free samples from under-sampled areas. While this approach alleviates the effects of sampling bias, in most scenarios this will not be a viable option due to the need for prior knowledge of an outbreak’s spatial distribution. We therefore consider an alternative model, the spatial Λ-Fleming-Viot process (ΛFV), which has recently gained popularity in population genetics. Despite the ΛFV’s robustness to sampling biases, we find that the different assumptions of the ΛFV and BMP models result in different applicabilities, with the ΛFV being more appropriate for scenarios of endemic spread, and BMP being more appropriate for recent outbreaks or colonizations.
Dynamic evolution of schistosomiasis distribution under different control strategies: Results from surveillance covering 1991–2014 in Guichi, China
Authors: Hu Yi , Bergquist Robert , Chen Yue , Ke Yongwen , Dai Jianjun , He Zonggui , Zhang Zhijie
Published: January 2021

Background

Since the founding of the China, the Chinese government, depending on the changing epidemiological situations over time, adopted different strategies to continue the progress towards elimination of schistosomiasis in the country. Although the changing pattern of schistosomiasis distribution in both time and space is well known and has been confirmed by numerous studies, the problem of how these patterns evolve under different control strategies is far from being understood. The purpose of this study is, therefore, to investigate the spatio-temporal change of the distribution of schistosomiasis with special reference to how these patterns evolve under different control strategies.

Methodology / Principal findings

Parasitological data at the village level were obtained through access to repeated cross-sectional surveys carried out during 1991–2014 in Guichi, a rural district along the Yangtze River in Anhui Province, China. A hierarchical dynamic spatio-temporal model was used to evaluate the evolving pattern of schistosomiasis prevalence, which accounted for mechanism of dynamics of the disease. Descriptive analysis indicates that schistosomiasis prevalence displayed fluctuating high-risk foci during implementation of the chemotherapy-based strategy (1991–2005), while it took on a homogenous pattern of decreasing magnitude in the following period when the integrated strategy was implemented (2006–2014). The dynamic model analysis showed that regularly global propagation of the disease was not present after the effect of proximity to river was taken into account but local pattern transition existed. Maps of predicted prevalence shows that relatively high prevalence (>4%) occasionally occurred before 2006 and prevalence presents a homogenous and decreasing trend over the study area afterwards.

Conclusions

Proximity to river is still an important determinant for schistosomiasis infection regardless of different types of implemented prevention and control strategies. Between the transition from the chemotherapy-based strategy to the integrated one, we noticed a decreased prevalence. However, schistosomiasis would remain an endemic challenge in these study areas. Further prevention and control countermeasures are warranted.
Vector competence of the African argasid tick Ornithodoros moubata for the Q fever agent Coxiella burnetii
Authors: Buysse Marie , Duhayon Maxime , Cantet Franck , Bonazzi Matteo , Duron Olivier
Published: January 2021

Q fever is a widespread zoonotic disease caused by the intracellular bacterium Coxiella burnetii. While transmission is primarily but not exclusively airborne, ticks are usually thought to act as vectors on the basis of early microscopy studies. However, recent observations revealed that endosymbionts of ticks have been commonly misidentified as C. burnetii, calling the importance of tick-borne transmission into question. In this study, we re-evaluated the vector competence of the African soft tick Ornithodoros moubata for an avirulent strain of C. burnetii. To this end, we used an artificial feeding system to initiate infection of ticks, specific molecular tools to monitor further infections, and culture assays in axenic and cell media to check for the viability of C. burnetii excreted by ticks. We observed typical traits associated with vector competence: The exposure to an infected blood meal resulted in viable and persistent infections in ticks, trans-stadial transmissions of infection from nymphs to adults and the ability of adult ticks to transmit infectious C. burnetii. However, in contrast to early studies, we found that infection differed substantially between tick organs. In addition, while adult female ticks were infected, we did not observe C. burnetii in eggs, suggesting that transovarial transmission is not effective. Finally, we detected only a sporadic presence of C. burnetii DNA in tick faeces, but no living bacterium was further isolated in culture assays, suggesting that excretion in faeces is not a common mode of transmission in O. moubata.
Congenital syphilis in Argentina: Experience in a pediatric hospital
Authors: Garcia Luciana Noemí , Destito Solján Alejandra , Moroni Samanta , Falk Nicolas , Gonzalez Nicolás , Moscatelli Guillermo , Ballering Griselda , García Bournissen Facundo , Altcheh Jaime M.
Published: January 2021

In spite of being preventable, Congenital syphilis (CS) is still an important, and growing health problem worldwide. Fetal infection can be particularly aggressive, but newborns can be asymptomatic at birth and, if left untreated, develop systemic compromise afterwards with poor prognosis. We analyzed 61 CS diagnosis cases between 1987–2019 presenting at the Buenos Aires Children’ Hospital. The distribution of cases showed a bimodal curve, with a peak in 1992–1993 and in 2014–2017. Median age at diagnosis was 2 months (IQ 1–6 months). The main clinical findings were: bone alterations (59%); hepatosplenomegaly (54.1%); anemia (62.8%); skin lesions (42.6%) and renal compromise (33.3%). Cerebrospinal fluid (CSF) was abnormal in 5 patients, normal in 45 and was not available for 11 patients. Remarkably, spinal lumbar puncture did not modify therapeutic decisions in any case. Between mothers, only 46% have been tested for syphilis during pregnancy and 60.5% patients had non-treponemal titers equal to or less than fourfold the maternal titer. Intravenous penicillin G was prescribed for all except one patient, who received ceftriaxone with good therapeutic response. During follow-up, 1.6% infants died, 6.5% had persistent kidney disorders and 1.6% showed bone sequelae damage. RPR titers decreased after treatment, reaching negative seroconversion in 43% subjects at a median of 26.4 months. Low adherence to follow up was observed due to inherent vulnerable and low-income population characteristics in our cohort. Our results highlight a rising tendency in cases referred for CS in our population with high morbidity related to delayed diagnosis. A good therapeutic response was observed. CS requires a greater effort from the health system to adequately screen for this disease during pregnancy, and to detect cases earlier, to provide an adequate diagnosis and treatment.
Phylogenetic diversity of 200+ isolates of the ectomycorrhizal fungus Cenococcum geophilum associated with Populus trichocarpa soils in the Pacific Northwest, USA and comparison to globally distributed representatives
Authors: Vélez Jessica M. , Morris Reese M. , Vilgalys Rytas , Labbé Jessy , Schadt Christopher W.
Published: January 2021

The ectomycorrhizal fungal symbiontCenococcum geophilumis of high interest as it is globally distributed, associates with many plant species, and has resistance to multiple environmental stressors.C.geophilumis only known from asexual states but is often considered a cryptic species complex, since extreme phylogenetic divergence is often observed within nearly morphologically identical strains. Alternatively,C.geophilummay represent a highly diverse single species, which would suggest cryptic but frequent recombination. Here we describe a new isolate collection of 229C.geophilumisolates from soils underPopulus trichocarpaat 123 collection sites spanning a ~283 mile north-south transect in Western Washington and Oregon, USA (PNW). To further understanding of the phylogenetic relationships withinC.geophilum, we performed maximum likelihood and Bayesian phylogenetic analyses to assess divergence within the PNW isolate collection, as well as a global phylogenetic analysis of 789 isolates with publicly available data from the United States, Japan, and European countries. Phylogenetic analyses of the PNW isolates revealed three distinct phylogenetic groups, with 15 clades that strongly resolved at >80% bootstrap support based on aGAPDHphylogeny and one clade segregating strongly in two principle component analyses. The abundance and representation of PNW isolate clades varied greatly across the North-South range, including a monophyletic group of isolates that spanned nearly the entire gradient at ~250 miles. A direct comparison between theGAPDHand ITS rRNA gene region phylogenies, combined with additional analyses revealed stark incongruence between the ITS andGAPDHgene regions, consistent with intra-species recombination between PNW isolates. In the global isolate collection phylogeny, 34 clades were strongly resolved using Maximum Likelihood and Bayesian approaches (at >80% MLBS and >0.90 BPP respectively), with some clades having intra- and intercontinental distributions. Together these data are highly suggestive of divergence within multiple cryptic species, however additional analyses such as higher resolution genotype-by-sequencing approaches are needed to distinguish potential species boundaries and the mode and tempo of recombination patterns.
Comprehensive genomic analysis reveals virulence factors and antibiotic resistance genes in Pantoea agglomerans KM1, a potential opportunistic pathogen
Authors: Guevarra Robin B. , Magez Stefan , Peeters Eveline , Chung Mi Sook , Kim Kyung Hyun , Radwanska Magdalena
Published: January 2021

Pantoea agglomeransis a Gram-negative facultative anaerobic bacillus causing a wide range of opportunistic infections in humans including septicemia, pneumonia, septic arthritis, wound infections and meningitis. To date, the determinants of virulence, antibiotic resistance, metabolic features conferring survival and host-associated pathogenic potential of this bacterium remain largely underexplored. In this study, we sequenced and assembled the whole-genome ofP.agglomeransKM1 isolated from kimchi in South Korea. The genome contained one circular chromosome of 4,039,945 bp, 3 mega plasmids, and 2 prophages. The phage-derived genes encoded integrase, lysozyme and terminase. Six CRISPR loci were identified within the bacterial chromosome. Further in-depth analysis showed that the genome contained 13 antibiotic resistance genes conferring resistance to clinically important antibiotics such as penicillin G, bacitracin, rifampicin, vancomycin, and fosfomycin. Genes involved in adaptations to environmental stress were also identified which included factors providing resistance to osmotic lysis, oxidative stress, as well as heat and cold shock. The genomic analysis of virulence factors led to identification of a type VI secretion system, hemolysin, filamentous hemagglutinin, and genes involved in iron uptake and sequestration. Finally, the data provided here show that, the KM1 isolate exerted strong immunostimulatory properties on RAW 264.7 macrophagesin vitro. Stimulated cells produced Nitric Oxide (NO) and pro-inflammatory cytokines TNF-α, IL-6 and the anti-inflammatory cytokine IL-10. The upstream signaling for production of TNF-α, IL-6, IL-10, and NO depended on TLR4 and TLR1/2. While production of TNF-α, IL-6 and NO involved solely activation of the NF-κB, IL-10 secretion was largely dependent on NF-κB and to a lesser extent on MAPK Kinases. Taken together, the analysis of the whole-genome and immunostimulatory properties provided in-depth characterization of theP.agglomeransKM1 isolate shedding a new light on determinants of virulence that drive its interactions with the environment, other microorganisms and eukaryotic hosts
Quantitative UV-C dose validation with photochromic indicators for informed N95 emergency decontamination
Authors: Su Alison , Grist Samantha M. , Geldert Alisha , Gopal Anjali , Herr Amy E.
Published: January 2021

With COVID-19 N95 shortages, frontline medical personnel are forced to reuse this disposable–but sophisticated–multilayer respirator. Widely used to decontaminate nonporous surfaces, UV-C light has demonstrated germicidal efficacy on porous, non-planar N95 respirators when all surfaces receive ≥1.0 J/cm2 dose. Of utmost importance across disciplines, translation of empirical evidence to implementation relies upon UV-C measurements frequently confounded by radiometer complexities. To enable rigorous on-respirator measurements, we introduce a photochromic indicator dose quantification technique for: (1) UV-C treatment design and (2) in-process UV-C dose validation. While addressing outstanding indicator limitations of qualitative readout and insufficient dynamic range, our methodology establishes that color-changing dosimetry can achieve the necessary accuracy (>90%), uncertainty (<10%), and UV-C specificity (>95%) required for UV-C dose measurements. In a measurement infeasible with radiometers, we observe a striking ~20× dose variation over N95s within one decontamination system. Furthermore, we adapt consumer electronics for accessible quantitative readout and use optical attenuators to extend indicator dynamic range >10× to quantify doses relevant for N95 decontamination. By transforming photochromic indicators into quantitative dosimeters, we illuminate critical considerations for both photochromic indicators themselves and UV-C decontamination processes.
A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors
Authors: Jong Mats , Lown E. Anne , Schats Winnie , Mills Michelle L. , Otto Heather R. , Gabrielsen Leiv E. , Jong Miek C.
Published: January 2021

Objectives

Systematic mapping of the concept, content, and outcome of wilderness programs for childhood cancer survivors.

Design

Scoping review.

Search strategy

Searches were performed in 13 databases and the grey literature. Included studies describe participation of childhood cancer survivors in wilderness programs where the role of nature had a contextual and therapeutic premise. At least two authors independently performed screening, data extraction and analysis.

Results

Database searches yielded 1848 articles, of which 15 met the inclusion criteria. The majority of programs (73%) employed adventure therapy. Five activity categories were identified as components of wilderness programs: challenge/risk, free time/leisure, experiential learning, physical activity and psychotherapeutic activities. A majority of the participating childhood cancer survivors were female, white, aged 8–40 years, with a wide range of cancer diagnoses. Reported outcomes included increased social involvement, self-esteem, self-confidence, self-efficacy, social support, and physical activity. Key gaps identified included the absence of randomized controlled trials (RCTs), lack of studies on long-term effects, lack of information on the multicultural aspects of programs, and missing information on engagement in nature activities after the program ended.

Conclusions

This scoping review guides childhood cancer survivors, their families, practitioners, clinicians and researchers in the development and optimization of wilderness programs for childhood cancer survivors. In addition, it informs the utilization of these programs, and identifies gaps in the evidence base of wilderness programs. It is recommended that future study reporting on wilderness programs include more detail and explicitly address the role of nature in the program. Performing RCTs on wilderness programs is challenging, as they occur in real-life contexts in which participants cannot be blinded. Creative solutions in the design of pragmatic trials and mixed method studies are thus needed for further investigation of the effectiveness and safety of wilderness programs in childhood cancer survivors.
The efficacy and safety of hydroxychloroquine for COVID-19 prophylaxis: A systematic review and meta-analysis of randomized trials
Authors: Lewis Kimberley , Chaudhuri Dipayan , Alshamsi Fayez , Carayannopoulos Laiya , Dearness Karin , Chagla Zain , Alhazzani Waleed ,   for the GUIDE Group
Published: January 2021

Background

Populations such as healthcare workers (HCW) that are unable to practice physical distancing are at high risk of acquiring Coronavirus disease-2019 (COVID-19). In these cases pharmacological prophylaxis would be a solution to reduce severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) transmission. Hydroxychloroquine has in vitro antiviral properties against SARS CoV-2. We therefore sought to determine the efficacy and safety of hydroxychloroquine as prophylaxis for COVID-19.

Methods and findings

We electronically searched EMBASE, MEDLINE, the Cochrane COVID-19 Register of Controlled Trials, Epistemonikos COVID-19, clinicaltrials.gov, and the World Health Organization International Clinical Trials Registry Platform up to September 28th, 2020 for randomized controlled trials (RCTs). We calculated pooled relative risks (RRs) for dichotomous outcomes with the corresponding 95% confidence intervals (CIs) using a random-effect model. We identified four RCTs (n = 4921) that met our eligibility criteria. The use of hydroxychloroquine, compared to placebo, did not reduce the risks of developing COVID-19 (RR 0.82, 95% CI 0.65 to 1.04, moderate certainty), hospitalization (RR 0.72, 95% CI 0.34 to 1.50, moderate certainty), or mortality (RR 3.26, 95% CI 0.13 to 79.74, low certainty), however, hydroxychloroquine use increased the risk of adverse events (RR 2.76, 95% CI 1.38 to 5.55, moderate certainty).

Conclusion

Although pharmacologic prophylaxis is an attractive preventive strategy against COVID-19, the current body of evidence failed to show clinical benefit for prophylactic hydroxychloroquine and showed a higher risk of adverse events when compared to placebo or no prophylaxis.
Depression and associated factors among HIV-positive youths attending antiretroviral therapy clinics in Jimma town, southwest Ethiopia
Authors: Girma Derara , Assegid Sahilu , Gezahegn Yenealem
Published: January 2021

Background

Depression is recognized as a prominent health problem and a growing public health concern in HIV-positive youths. Despite this fact, in Ethiopia, there is a dearth of evidence on the prevalence of depression and its associated factors among HIV-positive youths.

Methods

A facility-based cross-sectional study was conducted from March 16 to June 01, 2020, among 331 HIV-positive youths attending antiretroviral therapy clinics in Jimma town. A systematic random sampling technique was used to enroll study participants. Bivariable and multivariable logistic regression was done to identify factors associated with depression. Variables with a p-value ≤0.25 on the bivariable analysis were candidates for multivariable analysis. Adjusted odds ratios with the respective 95% CI were calculated and p-value <0.05 were used to set statistically significant variables in the multivariable analysis.

Results

Out of a total of 331 sampled HIV positive youth, 325 have participated in this study with a response rate of 98.2%. The prevalence of depression was 30.2% (95%CI:25.2%-35.1%). Female sex (AOR = 4.12, 95%CI:2.28–7.47), history of hospital admission (AOR = 2.45, 95%CI:1.28–4.70), discontinued education due to HIV/AIDS illness (AOR = 2.09, 95%CI:1.12–3.90), poor treatment adherence (AOR = 2.23, 95%CI:1.04–4.78), opportunistic infections (AOR = 2.16, 95%CI:1.17–3.97), high baseline viral load (AOR = 3.35, 95%CI:1.82–6.16) and ≤6 months duration of HIV diagnosis (AOR = 3.14, 95%CI: 1.47–5.72) were factors significantly associated with depression.

Conclusion

This study demonstrated a high prevalence of depression among HIV-positive youths. Factors such as female sex, treatment non-adherence, opportunistic infections, <six months since diagnosed with HIV, hospitalization history, high baseline viral load, and school discontinuation due to HIV/AIDS were significantly associated with depression. Therefore, we recommend regular screening for depression co-morbidity among HIV-positive youths and linkage with mental health service providers.
Design and ‘umamification’ of vegetable dishes for sustainable eating
Authors: Mouritsen Ole G. , Styrbæk Klavs
Published: January 2021

Food production is a main cause of the accelerating anthropogenic changes in the Earth’s ecosystems. There is an urgent need for global changes in the food production systems throughout the food chain as well as a call for a significant reduction in food waste. Sustainable and healthy eating has hence become a key issue on the global scene. The provision for a sustainable green transition involves eating more plant-based foods. The question then arises if such foods, e.g. vegetables, are sufficiently palatable for the carnivorous human whose evolution has been driven by meat-eating and a craving for umami taste for more than two million years. Is green food sufficiently delicious for us to eat more of it? This article describes an approach to sustainable eating of vegetables based on a combination of gastrophysical insights with culinary innovation and gastronomic design. Plant-based raw ingredients often lack the basic tastes umami and sweet and also need special attention regarding mouthfeel. As a result, a ‘taste rack’ of condiments, a kind of generalized spice rack or tasting inventory, which allows most vegetables to be turned into delicious dishes by ‘umamification’ and used effectively in a flexitarian setting, is developed. The power of the approach is illustrated by a number of case studies.
Figurations of taste: Sensing sustainable alternatives together
Authors: Højlund Susanne
Published: January 2021

Taste is a key analytical concept when we want to understand how people handle their food choices. But taste is an interdisciplinary concept that means different things, for example, to a chef, a farmer, a scientist and a sociologist. Using an empirical example, this opinion article argues that the gastronomical field embraces many meanings of taste and that this diversity needs to be nurtured rather than downplayed. It is suggested that research on social figurations can shed light on the endeavour to develop both new taste preferences and sustainable food practices.
Sex Differences in Extrahepatic Outcomes After Antiviral Treatment for Hepatitis C
Authors: Li Jia , Gordon Stuart C. , Zhou Yueren , Boscarino Joseph A. , Schmidt Mark A. , Daida Yihe G. , Rupp Loralee B. , Trudeau Sheri , Lu Mei ,   for the CHeCS Investigators
Published: January 2021

INTRODUCTION:

Despite recognized differences in the rates of cardiovascular and renal disease between men and women in the general population, studies of the downstream effects of antiviral treatment for hepatitis C (HCV) have not investigated differences in outcomes based on sex. We analyzed sex differences in risk of acute coronary syndrome (ACS), end-stage renal disease (ESRD), and ischemic stroke by treatment and response in a large US-based multisite cohort of HCV patients.

METHODS:

Observation started at the HCV diagnosis date (untreated) or last antiviral treatment start (treated). Treatment selection bias was addressed using an inverse probability-weighting approach. We estimated the effect of treatment on the cumulative incidence of outcomes using the Fine-Gray method (subdistribution hazard ratios [sHR] and 95% confidence intervals [95% CI]). Death was a competing risk.

RESULTS:

Roughly 40% of 15,295 HCV patients were women. After controlling for other risk factors, sustained virological response (SVR) (interferon-based [IFN] or direct-acting antiviral [DAA]) significantly reduced risk of all outcomes, particularly among female patients. Female patients who achieved SVR after IFN-based treatment had significantly lower risk of ACS compared with male patients with SVR from either treatment type (sHR 0.45 [95% CI 0.35–0.59] vs 0.81 [95% CI 0.69–0.96, for DAA SVR] and sHR 0.72 [95% 0.62, 0.85, for IFN SVR]). Successful treatment seemed to be most protective against ESRD; female patients who achieved SVR were at 66%–68% lower risk than untreated patients (sHR 0.32 [95% CI 0.17–0.60 for DAA SVR] and 0.34 [95% CI 0.20–0.58 for IFN SVR]), whereas men were at 38%–42% lower risk (sHR 0.62 [95% CI 0.46–0.85 for DAA SVR] and 0.58 [95% CI 0.43–0.76 for IFN SVR]). IFN treatment failure significantly increased risk of all outcomes by 50%–100% among female patients. Compared with no treatment, female patients who experienced IFN treatment failure were at 63% increased risk of ACS (sHR 1.63 [95% CI 1.35–1.96]), almost twice the risk of ESRD (sHR 1.95 [95% CI 1.43–2.66]) and 51% increased risk of stroke (sHR 1.49 [95%CI 1.11–2.00]).

DISCUSSION:

SVR reduced the risk of extrahepatic complications, particularly in females. The significantly increased risk associated with IFN TF in women—a subset who represented roughly 10% of that group—underscores the importance of prioritizing these patients for DAA treatment irrespective of the fibrosis stage.
Animal Welfare Ethics in Research and Testing: Implementation and its Barrier
Authors: Wahyuwardani Sutiastuti , Noor S M , Bakrie B
Published: January 2021

Animals have an important role in research and testing to improve human and animal health. Animal usage must be balanced between science and ethical values of animal welfare. This paper discusses the role of IACUC, the implications of animal welfare for research, animal ethical clearance and obstacles in the implementation of animal welfare. Institution of Animal Care Use Committee (IACUC) has an important role to ensure that researcher has animal ethical clearance before conducting research and testing. Research and testing using animal should comply with ethical principles: respect, beneficiary and justice; 3Rs principles: Replacement, Reduction, Refinement and 5F/Freedom: freedom from hunger and thirst, heat and discomfort, pain, trauma and disease, fear and stress and expressing behavior naturally. The application of animal ethics clearance in Indonesia in research using animals is compulsary in various institutions, However thera are several barriers in its implementation, Those are: not all research institutions have IACUC, lack of awareness of researchers to apply for animal ethical clearance, reluctant to IACUC requirements, lack of facilities animals that meet animal welfare requirements and lack of competence in animal handling according to animal welfare.
Верю-не-верю: общественное мнение и слухи о происхождении нового коронавируса
Authors: Климова Айгуль Маратовна , Чмель Кирилл Шамилевич , Савин Никита Юрьевич
Published: January 2021

Проблема ответа на сенситивные вопросы не имеет универсального решения и варьируется как по темам, так и по странам. Особенно актуальной она оказывается в моменты кризисов, когда непроверенная информация может рождать опасные социальные последствия. В нашем исследовании, проведенном на студентах одного крупного российского вуза, была апробирована техника непарных чисел для определения процента тех, кто верит слухам о причинах распространения COVID-19. С помощью применения этой техники мы обнаружили, что 15,6% студентов верят слухам. Данная доля была значительно выше в случае применения метода по сравнению с методом прямого вопроса. Работа подтверждает релевантность использования техники непарных чисел для изучения сенситивных вопросов и, в частности, веры граждан в неподтвержденные слухи.
Благодарность. Исследование выполнено за счет гранта Российского Фонда Фундаментальных Исследований № 20-011-31725 «Механизмы формирования общественного мнения в условиях кризисной медиа-повестки».