bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of Rift Valley Fever Virus Lineage H From South Africa Through the Syndromic Sentinel Surveillance Network in Senegal
Authors: Bob Ndeye Sakha , Barry Mamadou Aliou , Diagne Moussa Moise , Faye Martin , Ndione Marie Henriette Dior , Diallo Amadou , Diop Mamadou , Diop Boly , Faye Oumar , Loucoubar Cheikh , Fall Gamou , Faye Ousmane
Published: December 2021

Background

Rift Valley fever virus (RVFV) is an arbovirus that causes epizootics and epidemics among livestock population and humans. Our surveillance system has revealed multiple emergences and re-emergences of RVFV in West Africa over the last decade.

Methods

The Sentinel Syndromic Surveillance Network in Senegal (4S) has been implemented since 2011. Samples from human suspected arbovirus infection in 4S sentinel sites were sent to Institut Pasteur de Dakar (IPD), where arbovirus diagnosis by enzyme-linked immunosorbent assay (ELISA), real-time reverse transcription polymerase chain reaction (RT-PCR), and virus isolation was performed. Overall, IPD has received a total of 1149 samples from arboviral suspected patients through the 4S network from January to December 2020. These samples were screened for 7 arboviruses including RVFV. Whole-genome sequencing of positive RVFV samples by RT-PCR was performed using the Illumina Miseq platform followed by genome assembly. Phylogenetic analyses were performed using MEGA X.

Results

Out of the 1149 arbovirus suspected cases, 4 RVFV-positive samples were detected with RT-PCR while 5 RVFV-positive samples were detected by ELISA. Complete genome sequences were obtained for 3 strains among the 4 positive samples by RT-PCR. Phylogenetic analyses indicated an emergence of a virus first described in South Africa during a major outbreak.

Conclusions

This strong surveillance system allowed the detection of an RVFV outbreak in Senegal in 2020. The obtained genomes clustered with strains from South Africa belonging to lineage H. This calls for implementation of a strong surveillance system for wild animals, humans, and livestock simultaneously in all African countries.
Simulation-based spectral analysis of X-ray CCD data affected by photon pile-up
Authors: Tamba Tsubasa , Odaka Hirokazu , Bamba Aya , Murakami Hiroshi , Mori Koji , Hayashida Kiyoshi , Terada Yukikatsu , Mizuno Tsunefumi , Nobukawa Masayoshi
Published: December 2021

We have developed a simulation-based method of spectral analysis for pile-up-affected data of X-ray CCDs without any loss of photon statistics. As effects of the photon pile-up appear as complicated nonlinear detector responses, we employ a detailed simulation to calculate the important processes in an X-ray observation including physical interactions, detector signal generation, detector readout, and a series of data reduction processes. This simulation naturally reproduces X-ray-like and background-like events as results of X-ray photon merging in a single pixel or in a chunk of adjacent pixels, allowing us to construct a nonlinear spectral analysis framework that can treat pile-up-affected observation data. For validation, we have performed data analysis of Suzaku X-ray Imaging Spectrometer (XIS) observations using this framework with various parameters of the detector simulation, all of which are optimized for that instrument. We present three cases of different pile-up degrees: PKS 2155−304 (negligible pile-up), Aquila X-1 (moderate pile-up), and the Crab Nebula (strong pile-up); we show that the nonlinear analysis method produces results consistent with a conventional linear analysis for the negligible pile-up condition, and accurately corrects well-known pile-up effects such as spectral hardening and flux decrease for the pile-up cases. These corrected results are consistent with those obtained by a widely used core-exclusion method or by other observatories with much higher timing resolutions (without pile-up). Our framework is applicable to any types of CCDs used for X-ray astronomy, including future missions such as X-ray Imaging and Spectroscopy Mission (XRISM), by appropriate optimization of the simulation parameters.
Low Risk for Persistent Back Pain Disability Is Characterized by Lower Pain Sensitivity and Higher Physical Performance
Authors: Butera Katie A , Fox Emily J , Bishop Mark D , Coombes Stephen A , Beneciuk Jason M , George Steven Z
Published: December 2021

Objective

The STarT Back Tool (SBT) predicts risk for persistent low back pain (LBP)-related disability based on psychological distress levels. Other non-psychological factors associated with LBP, such as pain sensitivity and physical performance, may further characterize SBT-risk subgroups. The purpose of this study was to determine whether a low-risk SBT subgroup demonstrated lower pain sensitivity and/or higher physical performance compared with a medium-/high-risk SBT subgroup.

Methods

In this cross-sectional, secondary analysis, adults with LBP (N = 76) completed SBT and demographics (age, sex, race, chronicity) questionnaires. Participants underwent pain sensitivity (local and remote pressure pain thresholds, temporal summation, conditioned pain modulation) and physical performance (Back Performance Scale, walking speed, obstacle negotiation, Timed “Up & Go” [TUG], TUG Cognitive) testing. Independent samples t tests determined low- versus medium-/high-risk SBT subgroup differences. A follow-up discriminant function analysis was also conducted.

Results

The medium-/high-risk subgroup demonstrated a lower proportion of participants with acute pain. The low-risk subgroup demonstrated lower pain sensitivity (higher local pressure pain thresholds and higher conditioned pain modulation) and higher physical performance (superior Back Performance Scale scores, faster walking speeds, faster obstacle approach and crossing speeds, and faster TUG completion). Discriminant function analysis results supported the 2-subgroup classification and indicated strong to moderate relationships with obstacle crossing speed, chronicity, and conditioned pain modulation.

Conclusion

Lower pain sensitivity and higher physical performance characterized the low-risk SBT subgroup and may represent additional LBP prognostic factors associated with persistent disability. Longitudinal studies are needed to confirm whether these factors can enhance SBT prediction accuracy and further direct treatment priorities.

Impact

Sensory and physical factors contribute to SBT risk classification, suggesting additional, non-psychological factors are indicative of favorable LBP outcomes. Findings highlight the need for assessment of multiple factors to improve LBP clinical prediction.

Lay Summary

People at low risk for back pain disability have less sensitivity to pain and better physical performance. By measuring these factors, physical therapists could guide treatment and improve outcomes for people with back pain.
Association of physical activity on blood glucose in individuals with type 2 diabetes
Authors: Wang Yajuan , Dzubur Eldin , James Roberta , Fakhouri Tamer , Brunning Scott , Painter Stefanie , Madan Anmol , Shah Bimal R
Published: December 2021

Regular physical activity (PA) has been shown to improve glycemic control in persons with type 2 diabetes. This study aimed to investigate the impact of PA on blood glucose after controlling for medication use, demographics, and week of activation using a real-world population of individuals with type 2 diabetes. A longitudinal, retrospective study was performed evaluating weekly PA of Livongo members (N = 9,509), which analyzed fasting blood glucose (FBG), step counts, and daily active minutes. Linear mixed-effect modeling technique was used to investigate within member and between member effects of input variables on average weekly FBG. Of members enrolled, 6,336 (32%) had self-reported body mass index, qualified week with diabetes medications, and FBG measures. Members’ baseline average age was 49.4 (SD 10.1) years old, 43% female, and 45,496 member weeks with an average of 7.2 qualified weeks (PA observable in ≥4 days) per member. Average weekly FBG was 140.5 mg/dL (SD 39.8), and average daily step counts were 4,833 (SD 3,266). Moving from sedentary (<5,000 steps per day) to active (≥5,000 steps per day) resulted in mean weekly FBG reduction of 13 mg/dL (95% CI: −22.6 to −3.14). One additional day of ≥8,000 steps reduced mean weekly FBG by 0.47 mg/dL (95% CI: −0.77 to −0.16). Members who completed 30 min of moderate to vigorous PA above the population average reduced mean weekly FBG by 7.7 mg/dL (95% CI: −13.4 to −2.0). PA is associated with a mean weekly FBG reduction of 13 mg/dL when changing from a sedentary to active lifestyle while participating in a remote diabetes monitoring program.
A new strategy of enteral nutrition intervention for ICU patients targeting intestinal flora
Authors: Guo Yangyang , Xu Ming , Shi Guangzhi , Zhang Jindong
Published: December 2021

Background:

Enteral nutrition (EN) therapy is a routine supportive method for patients in the intensive care unit (ICU). However, the incidence of EN intolerance is prevalent, because most ICU patients suffer intestinal mucosal barrier damage and gastrointestinal motility disorder. There is no definite index to predict EN intolerance, and the current treatment methods are not effective in alleviating EN intolerance. Gut microbiota is an important component of the intestinal micro-ecological environment, and alterations in its structure and composition can reflect changes in intestinal function and microenvironment. The purpose of this study is to investigate the effect of EN on the gut microbiota of ICU patients by monitoring the dynamic alterations of gut microbiota and to screen out the microbial markers that can be used to predict the incidence of EN intolerance.

Methods:

One hundred ICU patients with trauma or in a period of acute stress after surgery will be enrolled, and their fecal samples will be collected at different timepoints for microbial sequencing and analysis. General clinical data (demographic information, surgical data, laboratory parameters, illness severity scores, and therapeutic drugs), nutritional status data (nutritional status assessment and nutrition therapy monitoring data), as well as clinical outcomes, will be recorded. The microbial and clinical data will be combined to analyze the baseline characteristics and dynamic alterations of gut microbiota along with the incidence of EN intolerance. Data related to the gut microbiota will be statistically analyzed by R software, and other data performed by SPSS23.0 software.

Conclusions:

The effect of EN on gut microbiota and microbial markers predicting the intolerance of EN will lead us to develop a new nutrition intervention strategy for ICU patients. Furthermore, the results of this study will provide a basis for the discovery of potential probiotics used for the prevention and treatment of EN intolerance.
Evaluation index system of education quality for nursing professional degree postgraduate using the analytic hierarchy process
Authors: Wei Wentong , Liu Jingying , Liu Yanhui , Kang Yannan , Luo Ruzhen , Zhang Xiaohong
Published: December 2021

Nursing is an inseparable job with the healthy life of human beings. High-level nursing talents have a greater influence on patients. It is the future trend for schools to train Nursing Professional Degree Postgraduate, and the evaluation of their education quality is the top priority.

To construct the education quality evaluation index system of Nursing Professional Degree Postgraduate and to determine the weight of each indicator.

Firstly, the indicators of the evaluation index system of education quality were identified from the literature review. Meanwhile, the Delphi questionnaire was designed and 13 experts evaluated and rated the indictors who were invited to conduct two rounds of the questionnaire. The weights associated with the factors were determined using the analytic hierarchy process and percentage methods, Finally, we developed the evaluation index system of education quality for a postgraduate nursing professional degree.

The evaluation system consisted of 4 first-level indicators, 17 second-level indicators, and 71 third-level indicators. According to the weights computed by analytic hierarchy process, first-level indicators are ranked as “Input quality” (0.1273), “Process quality” (0.3111), “Output quality” (0.0846), “Development quality” (0.4770). Among the secondary indicators, experts pay the most attention to career development (0.3180). The top three indicators of third-level indicators are workplace (0.2385), matching degree between personal expectations and job opportunities (0.1272), and promotion opportunities (0.0795).

The quality index system of nursing postgraduate education is scientific and reliable, and the weight distribution is reasonable. It is an effective tool for evaluating the quality of nursing graduate education.
Pre-operative nutrition assessments do not improve outcomes in cerebral palsy patients undergoing varus derotational osteotomy
Authors: Obana Kyle K. , Fan Bensen B. , Bennett James T. , Lin Adrian , Goldstein Rachel Y. , Andras Lindsay M. , Kay Robert M.
Published: December 2021

Pre-operative nutritional assessments have been used as a “cornerstone” to help optimize nutritional status and weight in children with cerebral palsy (CP) to lower the risk of postoperative complications. However, the potential value of nutritional assessments on surgical outcomes in patients with CP undergoing major orthopedic surgery remains unproven.

Do pre-operative nutritional assessments reduce complication rates of varus derotational osteotomy surgery in children with CP? Are complication rates higher in patients with a gastrostomy tube (G-tube) and can they be decreased by pre-operative nutritional assessment?

One-hundred fifty-five patients with CP who underwent varus derotational osteotomy from January 1, 2012 through December 31, 2017 at a tertiary pediatric hospital with minimum 6 months follow-up were retrospectively identified. One-hundred-ten (71%) were categorized as “non-ambulatory” (Gross Motor Function Classification System [GMFCS] IV–V), and 45 (29%) as “ambulatory” (GMFCS I–III). Variables assessed included age, GMFCS level, G-tube, body mass index (BMI) percentile, complications, and if patients underwent pre-operative nutritional assessment.

One-hundred-eleven patients (71.6%) underwent pre-operative nutritional assessment. Sixty-two of 155 patients (40.0%) had G-tubes. In non-ambulatory patients with G-tubes, BMI percentile changes were not significantly different between patients with a pre-operative nutritional assessment compared to those without at 1 (P = .58), 3 (P = .61), 6 (P = .28), and 12 months (P = .21) postoperatively. In non-ambulatory patients who underwent pre-operative nutritional assessment, BMI percentile changes were not significantly different between those with and without G-tubes at 1 (P = .61), 3 (P = .71), 6 (P = .19), and 12 months (P = .10). Pulmonary complication rates were significantly higher in non-ambulatory patients with G-tubes than in non-ambulatory patients without G-tubes (20% vs 4%, P = .03). Pre-operative nutritional assessments did not influence postoperative complication rates for non-ambulatory patients with or without a G-tube (P = .12 and P = .16, respectively). No differences were found in postoperative complications between ambulatory patients with and without G-tubes (P = .45) or between ambulatory patients with or without nutritional assessments (P = .99).

Nutritional assessments, which may improve long term patient nutrition, should not delay hip surgery in patients with CP and progressive lower extremity deformity. Patients and their families are unlikely to derive any short-term nutritional improvement using routine pre-operative evaluation and surgical outcomes are unlikely to be improved.

Level of Evidence: III, retrospective comparative.
Secondary synovial chondromatosis of the subacromial subdeltoid bursa with coexisting glenohumeral osteoarthritis
Authors: Lee Hyun June , Han Weoncheol , Kim Kyungil
Published: December 2021

Rationale:

Synovial chondromatosis of the shoulder joint is uncommon; this condition usually affects the knee joint and the hip joint. Lesions of multiple chondral nodules form in the synovium and are usually found within the joint capsule. Treatment of synovial chondromatosis consists of loose body removal and synovectomy. In synovial chondromatosis of the shoulder, arthroscopic loose body removal and synovectomy have been reported with good outcomes. Arthroplasty can be a treatment option when osteoarthritis co-occurs at the affected joint. Since incidence of glenohumeral joint osteoarthritis is low compared to osteoarthritis of the knee or hip joints, reports of shoulder synovial chondromatosis treated with arthroplasty are scarce.

Patient concerns:

A 79-year-old woman presented with right shoulder pain with loss of motion for several years without a history of trauma.

Diagnoses:

Degenerative changes in the humeral head and glenoid were noted and multiple loose bodies were found in the subdeltoid bursa, and the subacromial bursa. The pathology of loose bodies showed degenerated cartilage tissue and some bony components. Characteristic concentric rings of calcification were observed, indicative of secondary synovial chondromatosis. The diagnosis was secondary synovial chondromatosis of the subacromial subdeltoid bursa with coexisting glenohumeral osteoarthritis.

Interventions:

The patient was treated with loose body removal, extensive synovectomy, bursectomy and reverse total shoulder arthroplasty.

Outcomes:

Visual analog scale for shoulder pain, range of motion of shoulder joint had improved demonstrating a good short-term outcome and there was no radiographic evidence of disease recurrence.

Lessons:

In synovial chondromatosis of the shoulder, loose bodies may form in the bursa. In combination with degenerative osteoarthritis of the glenohumeral joint, arthroplasty is a viable option.
Improved oral hygiene care and chronic kidney disease occurrence
Authors: Chang Yoonkyung , Lee Ji Sung , Woo Ho Geol , Ryu Dong-Ryeol , Kim Jin-Woo , Song Tae-Jin
Published: December 2021

Oral diseases or poor oral hygiene have close connections with systemic inflammatory reaction, which is one of major mechanism in the development of chronic kidney disease (CKD). We conducted a research assuming that better oral hygiene care would be negatively related with the risk of developing new-onset CKD.

From 2003 to 2004, a total of 158,495 participants from the Korean national health insurance data sharing service which provides health screening data including variables as age, sex, vascular risk factors, medication information, indicators regarding oral hygiene, and laboratory results. The diagnosis of CKD and vascular risk factors were defined according to the International Statistical Classification of Diseases and Related Health Problems codes-10th revision. The follow-up period for the study subject was until the occurrence of CKD, until death, or Dec 31, 2015.

Approximately 13.3% of the participants suffered from periodontal disease, and 40.7% brushed their teeth at least three times a day. With a median of 11.6 (interquartile range 11.3–12.2) years’ follow-up, the cohort included 3223 cases of incident CKD. The 10-year incidence rate for CKD was 1.80%. In multivariable analysis with adjustment for age, sex, demographics, vascular risk factors, blood pressure, and blood laboratory results, frequent tooth brushing (≥3 times a day) was negatively related to occurrence of CKD (hazard ratio: 0.90, 95% confidence interval [0.83–0.99],
P
 
= 
.043, P value for trend 
= 
.043).Participants with improved oral hygiene (≥3 times a day) have showed less risk of CKD. Additional interventional studies are in need to establish causative relationship between oral hygiene and risk of CKD.
Disseminated tuberculosis mimicking abdominal metastatic carcinoma
Authors: Zhou Qi , Zhang MiaoXin
Published: December 2021

Rationale:

Extra-pulmonary tuberculosis (TB) has long been a diagnostic challenge for clinicians, often requiring extensive workup and invasive procedures, with the risk of significant complications. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a minimally invasive and highly accurate diagnostic modality for the evaluation of mediastinal and abdominal lymphadenopathy and masses. Several reports on the utility of EUS-FNA as a favorable method for diagnosing extrapulmonary TB have been published.

Patient concerns:

A 54-year-old man complained of intermittent melena.

Diagnoses:

18 fluorine-fluorodeoxyglucose positron emission tomography/computed tomography revealed suspected carcinoma metastasis. EUS-FNA did not reveal any evidence of malignancy.

Interventions and outcomes:

Laparoscopy was performed, and frozen section pathology during surgery showed granulomas with focal necrosis. Mycobacterium tuberculosis polymerase chain reaction was positive, but acid-fast bacilli staining was negative. Anti-TB treatment was initiated, and the patient was advised to visit the local TB dispensary regularly.

Lessons:

The presence of atypical inflammation of inadequate material or non-representative samples of extra-pulmonary TB was observed on EUS-FNA cytology. Mycobacterium tuberculosis polymerase chain reaction and acid fast bacilli should be performed to diagnose TB because of its higher sensitivity.
Acute hemolysis and methemoglobinemia secondary to fava beans ingestion in a patient with G6PD deficiency
Authors: Al-Dubai Husam , Al-Mashdali Abdulrahman , Hailan Yousef
Published: December 2021

Rationale:

Favism is a well-known cause of acute hemolytic anemia. Rarely, methemoglobinemia can also happen because of fava bean ingestion in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Few cases with this co-occurrence have been reported in the literature.

Patient concerns:

We report a case of a 47-year-old patient who presented with jaundice that started 2 days after eating fava beans.

Diagnoses:

Laboratory investigations revealed anemia with evidence of hemolysis (high reticulocytes count, high indirect bilirubin, bite cells in peripheral smear). Blood gases showed high methemoglobin level. Reduced level of G6PD enzyme confirmed the diagnosis of G6PD deficiency.

Intervention:

The patient was kept on supplemental oxygen. He was counselled to avoid food and drugs that can cause acute hemolysis.

Outcomes:

Oxygen saturation improved gradually. The patient was discharged without any complications after 2 days.

Lessons:

Patients with G6PD deficiency can develop both acute hemolytic anemia and methemoglobinemia secondary to fava beans ingestion. These patients should not receive methylene blue to avoid worsening hemolysis.
Associations of cardiovascular risk factors with survival outcomes in a cancer registration
Authors: Maki Yuji , Sueta Daisuke , Ishii Masanobu , Yamanouchi Yoshinori , Fujisue Koichiro , Yamanaga Kenshi , Nakamura Taishi , Tabata Noriaki , Arima Yuichiro , Araki Satoshi , Yamamoto Eiichiro , Kaikita Koichi , Chikamoto Akira , Matsushita Kenichi , Matsuoka Masao , Usuku Koichiro , Tsujita Kenichi
Published: December 2021

Although the relationship between cardiovascular diseases and malignant diseases has recently attracted attention, the associations of cardiovascular risk factors and clinical outcomes in cancer patients remain to be elucidated. We performed a retrospective, observational study that explored the clinical outcomes of patients with cancer or with a history of cancer.

We enrolled 30,706 consecutive adult cancer patients from Kumamoto University Hospital. We investigated mortality and morbidity, including cardiovascular conditions (dyslipidemia [DL]/diabetes mellitus [DM]/hypertension [HT]). The primary endpoint was all-cause mortality.

Of the enrolled patients, 9032 patients (29.4%) died within the follow-up period. The Kaplan–Meier analysis demonstrated that in the groups classified according to the number of DL/DM/HT (LDH) factors, the LDH1 and LDH2 groups had a significantly higher probability of the primary endpoint than the LDH0 group (P < .001 and P < .001, respectively), whereas there were no significant differences between the LDH0 group and LDH3 group (P = .963). Univariate Cox proportional hazards regression analyses of mortality complemented by the multiple imputation method including various factors demonstrated that the presence of DL in cancer patients was a significant negative predictor of mortality (hazard ratio = 0.79, P < .01).

The all-cause mortality rate did not always increase as the number of LDH factors increased. The present study revealed that the presence of DL is a negative risk factor for all-cause mortality in cancer patients.
Lasso loop technique using bioabsorbable thread to treat intra-articular distal radius fracture
Authors: Kaji Yoshio , Yamaguchi Konosuke , Nomura Yumi , Oka Kunihiko , Shimamura Masashi , Kawakami Shohei , Yamamoto Tetsuji
Published: December 2021

This article introduces our lasso loop technique (LLT) using a bioabsorbable thread for the treatment of intra-articular distal radius fractures with displaced dorsal bone fragment containing articular surface (DBF). We also examined whether the articular gap is sufficiently reduced and maintained by the LLT, along with the results of other radiological and clinical evaluations. We retrospectively reviewed 19 patients who underwent LLT for intra-articular distal radius fracture with a displaced DBF. Patient radiographic images and medical records were used to investigate radiological characteristics, symptoms, physical findings, and the Quick Disabilities of the Arm, Shoulder, and Hand scores. Sagittal-view computed tomography showed that the mean preoperative articular gap was 2.6 mm, but the gap was reduced by LLT, and the gap immediately postoperatively was <1.0 mm in all patients. No re-displacement of the DBF was evident from immediately postoperatively to 6 months postoperatively. Postoperatively, no losses of correction in palmar tilt, radial inclination, or ulnar variance were seen in the evaluation of plain radiographs, and satisfactory joint range of motion, grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand score were obtained. No significant complications due to LLT were observed. LLT appears to offer a simple and effective procedure to reduce displaced DBF with little risk of complications. LLT may become a useful option in the treatment of intra-articular distal radius fractures with displaced DBF.
Acupuncture plus Tuina for chronic insomnia
Authors: Yang Weiwan , Guo Xiaole , Lu Qi , Pan Ting , Wang Haili , Wang Hongfeng
Published: December 2021

Background:

Insomnia is a common sleep disorder. It refers to a subjective feeling of dissatisfaction with sleep duration and quality that affects social functioning, even though there are appropriate opportunities and environments for sleep. The disease for a long time can easily cause physical and mental fatigue, anxiety, depression, and other symptoms. Anxiety, depression, and insomnia can worsen the condition. Acupuncture and Tuina therapy has been widely used in the treatment of chronic insomnia, and this study aimed to conduct a meta-analysis of acupuncture plus Tuina in the treatment of chronic insomnia to clarify its efficacy.

Methods:

The following databases will be searched: Web of Science, PubMed, Cochrane Library, Embase, and Medline databases. In addition, we will also collect 4 databases of China: China National Knowledge Infrastructure, China Biomedical Literature Database, VIP Database, and Wan-fang Database. We selected eligible studies published up to October 2021. We used Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture plus Tuina for chronic insomnia were included in this study. Language is limited to both Chinese and English languages. Study selection, data extraction, and study quality assessment were independently performed by 2 researchers. We then assessed the quality and risk of the included studies and observed the outcome indicators.

Results:

This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture plus Tuina for treating chronic insomnia.

Conclusion:

This systematic review will provide evidence to determine whether acupuncture plus Tuina is an effective and safe intervention for patients with chronic insomnia.

Ethics and dissemination:

The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

Registration number:

INPLASY2021100115
Epidemiology, methodological quality, and reporting characteristics of systematic reviews and meta-analyses on coronavirus disease 2019
Authors: Chen Yuehong , Li Ling , Zhang Qiuping , Liu Huan , Huang Yupeng , Lin Sang , Yin Geng , Xie Qibing
Published: December 2021

During the coronavirus disease 2019 (COVID-19) pandemic, convenient accessibility and rapid publication of studies related to the ongoing pandemic prompted shorter preparation time for studies. Whether the methodological quality and reporting characteristics of published systematic reviews (SRs)/meta-analyses are affected during the specific pandemic condition is yet to be clarified. This study aimed to evaluate the epidemiology, methodological quality, and reporting characteristics of published SRs/meta-analyses related to COVID-19.

The Ovid Medline, Ovid Embase, Cochrane Library, and Web of Science electronic databases were searched to identify published SRs/meta-analyses related to the COVID-19 pandemic. Study screening, data extraction, and methodology quality assessment were performed independently by 2 authors. The methodology quality of included SRs/meta-analyses was evaluated using revised version of a measurement tool to assess SRs, and the reporting characteristics were assessed based on the preferred reporting items for SRs and meta-analyses guidelines.

A total of 47 SRs/meta-analyses were included with a low to critically low methodological quality. The median number of days from the date of literature retrieval to the date that the study was first available online was 21 days; due to the limited time, only 7 studies had study protocols, and the studies focused on a wide range of COVID-19 topics. The rate of compliance to the preferred reporting items for SRs and meta-analyses checklists of reporting characteristics ranged from 14.9% to 100%. The rate of compliance to the items of protocol and registration, detailed search strategy, and assessment of publication bias was less than 50%.

SRs/meta-analyses on COVID-19 were poorly conducted and reported, and thus, need to be substantially improved.
Diagnostic performance of quantitative and qualitative elastography for the differentiation of benign and malignant cervical lymph nodes
Authors: Jia Zhaohua , Qu Meijing , Sun Lipeng , Wang Hui
Published: December 2021

Background:

Studies have shown inconsistent results regarding the diagnostic performance of quantitative and qualitative elastography for the differentiation of benign and malignant cervical lymph nodes. This meta-analysis aimed to estimate the diagnostic performance of ultrasound elastography in patients with cervical lymphadenopathy.

Methods:

We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the May 30, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:

This systematic review will determine the accuracy of shear wave elastography and strain elastography in the differential diagnosis between benign and malignant cervical lymph nodes.

Conclusion:

Its findings will provide helpful evidence for the accuracy of shear wave elastography and strain elastography in the differential diagnosis between benign and malignant cervical lymph nodes.

Systematic review registration:

INPLASY202150109.
Relapsing cerebral atypical teratoid/rhabdoid tumor after trimodality therapy
Authors: Meng Linlin , Wang Linlin , Shao Guangrui
Published: December 2021

Introduction:

Atypical teratoid rhabdoid tumor (AT/RT) is a high-grade embryonal malignant neoplasm of the central nervous system. It is rare and most often diagnosed in children <4 years of age. The biological manifestations of AT/RTs are highly malignant and have a very poor prognosis. Here, we present the case of a 16-year-old boy with AT/RT in the right parietal lobe and with a dismal outcome.

Patient concerns:

A 16-year-old male boy presented with a headache after waking up for 1 year without obvious cause. The pain was persistent and dull, mainly in the right orbital, and was slightly relieved after pressing the orbital. Occasionally, nausea and vomiting occurred, and the vomiting was gastric contents. Examination and head computed tomography performed at a local hospital revealed a space-occupying lesion in the right parietal lobe. The patient was then transferred to our hospital for further diagnosis and treatment.

Diagnosis:

The patient underwent craniotomy and gross total excision of the tumor. Further histologic examination of the tumor was identified (space-occupying lesion in the right parietal lobe) AT/RT, World Health Organization grade IV.

Interventions:

The patient was transferred to the oncology department for radiotherapy and chemotherapy after surgery recovery.

Outcomes:

The patient did not comply with the advice for adjuvant chemotherapy regularly and the tumor recurred rapidly. Finally, the patient died after 18 months after the definitive surgery.

Conclusion:

In conclusion, in the presence of a tumor with peripheral cystic components or hemorrhage in young children, a diagnosis of AT/RT must always be considered. Patients must follow the doctor's advice for active treatment. All relevant data are within the paper and its Supporting Information files.
Immunosequencing and epitope mapping reveal substantial preservation of the T cell immune response to Omicron generated by SARS-CoV-2 vaccines
Authors: May Damon H. , Rubin Benjamin E. R. , Dalai Sudeb C. , Patel Krishna , Shafiani Shahin , Elyanow Rebecca , Noakes Matthew T. , Snyder Thomas M. , Robins Harlan S.
Published: December 2021

The Omicron SARS-CoV-2 variant contains 34 mutations in the spike gene likely impacting protective efficacy from vaccines. We evaluated the potential impact of these mutations on the cellular immune response. Combining epitope mapping to SARS-CoV-2 vaccines that we have determined from past experiments along with T cell receptor (TCR) repertoire sequencing from thousands of vaccinated or naturally infected individuals, we estimate the abrogation of the cellular immune response in Omicron. Although 20% of CD4+ T cell epitopes are potentially affected, the loss of immunity mediated by CD4+ T cells is estimated to be slightly above 30% as some of the affected epitopes are relatively more immunogenic. For CD8+ T cells, we estimate a loss of approximately 20%. These reductions in T cell immunity are substantially larger than observed in other widely distributed variants. Combined with the expected substantial loss of neutralization from antibodies, the overall protection provided by SARS-CoV-2 vaccines could be impacted adversely. From analysis of prior variants, the efficacy of vaccines against symptomatic infection has been largely maintained and is strongly correlated with the T cell response but not as strongly with the neutralizing antibody response. We expect the remaining 70% to 80% of on-target T cells induced by SARS-CoV-2 vaccination to reduce morbidity and mortality from infection with Omicron.
Post COVID-19 1st Dose Vaccination Common Symptoms among SE Asia College Students
Authors: Yostyadiananda Natasya O. , Gunawan Gabriella R.A. , Wibowo Andri
Published: December 2021

In the second year of the COVID-19 epidemic in the Southeast Asia (SE) regions, there is a plan to reopen the school, including the campus. Among students in Indonesia, college students have a population of almost 8.3 million. Considering the massive numbers of college students, school reopening should be supported by adequate COVID-19 vaccination. As a result, the first dose of the inactivated virus COVID-19 vaccine has been administered, including to college students aged over 18 years old. While COVID-19 vaccination is widely available, there is still a scarcity of information on post-vaccination symptoms. As reported from other locations, post vaccination has been reported. Then, this study aims to assess the common symptoms of COVID-19 1st dose vaccinations among the following groups: gender (male and female college students), age, body weight, and height. The observed symptoms include sore arms, fatigue, headache, fever with a body temperature above 38 °C, nausea, shivering, and muscle joint pain. Participants in this study were students at the university. They were considered eligible for this study if they were currently enrolled at university, were at least 19 years of age, and provided informed consent. The data was recorded using a standardized online questionnaire. The answers were collected in an online database. At the beginning of the questionnaire, subjects or students were informed that data would be collected anonymously. Based on the results, the symptoms were different between female and male students. In fact, female students have experienced more symptoms than male students. While male students only suffered sore arms (68%) followed by headache symptoms (32%). Similar to male students, sore arms are the most common symptom observed among female students. Among female students, from the most to the least common symptoms observed from 20 years of age in this study are sore arms at site reaction > headache > fatigue > fever > muscle joint pain > shivering > nausea. A higher risk of presenting fatigue and headache symptoms was found in those with a non-overweight status with weight ranges of 50-60 kg.
Reliably Assessing Duration of Protection for COVID-19 Vaccines
Authors: Lin Dan-Yu , Zeng Donglin , Gu Yu , Fleming Thomas R , Krause Philip R
Published: December 2021

Decision-making about booster dosing for COVID-19 vaccine recipients hinges on reliable methods for evaluating the longevity of vaccine protection. We show that modeling of protection as a piecewise linear function of time since vaccination for the log hazard ratio of the vaccine effect provides more reliable estimates of vaccine effectiveness at the end of an observation period and also more reliably detects plateaus in protective effectiveness as compared with the traditional method of estimating a constant vaccine effect over each time period. This approach will be useful for analyzing data pertaining to COVID-19 vaccines and other vaccines where rapid and reliable understanding of vaccine effectiveness over time is desired.
Detection of the omicron variant virus with the Abbott BinaxNow SARS-CoV-2 Rapid Antigen Assay
Authors: Regan James , Flynn James P. , Choudhary Manish C. , Uddin Rockib , Lemieux Jacob , Boucau Julie , Bhattacharyya Roby P. , Barczak Amy K. , Li Jonathan Z. , Siedner Mark J.
Published: December 2021

The US Centers for Disease Control and Prevention recommends rapid testing for SARS-CoV-2 infection as a key element of epidemic control. The Abbott BinaxNow is in widespread use in the United States for self-testing and as part of public health screening campaigns, but has not been evaluated for use with the omicron variant of SARS-CoV-2. We recruited individuals testing positive for COVID-19 PCR at an academic medical center. Anterior nasal swabs were stored in viral transport media and evaluated by viral load quantification and whole genome sequencing. We created serial dilutions from 2.5×103-2.5×105 viral copies/specimen for two delta and omicron specimens, respectively, and tested each with the BinaxNow assay per manufacturer instructions. Results were interpreted by three readers, blinded to the specimen variant and concentration. All omicron and delta specimens with concentrations of 100,000 copies/swab or greater were positive by the BinaxNow Assay, a concentration similar to previously reported limits of detection for this assay. Assay sensitivity diminished below that. This study demonstrates that Omicron variant SARS-CoV-2 infections are detected by the BinaxNow rapid antigen assay. Additional laboratory and clinical validation assessments are needed to better determine their limits of detection and performance in real-world settings.
Elevation of cell-associated HIV-1 RNA transcripts in CSF CD4+ T cells, despite suppressive antiretroviral therapy, is linked to in vivo brain injury
Authors: Suzuki Kazuo , Zaunders John , Gates Thomas M. , Levert Angelique , Butterly Shannen , Liu Zhixin , Ishida Takaomi , Huang Chin-Shiou , Palmer Sarah , Rae Carolin D. , Jugé Lauriane , Cysique Lucette A. , Brew Bruce J.
Published: December 2021

Objective

Despite effective antiretroviral therapy (ART), brain injury remains prevalent in people living with HIV-1 infection (PLHIV) possibly due to ART’s lack of direct inhibition of transcription with continued local production of viral transcripts and neurotoxic proteins, such as Tat, rather than cell-free whole virion toxicity. We quantified cell-associated (CA) HIV-1 RNA-transcripts in CSF and blood, in relation to proton Magnetic Resonance Spectroscopy (1H MRS) of major brain metabolites, in well characterised PLHIV.

Methods

RNA was extracted from cells in 16 paired samples of CSF and blood, from PLHIV on fully suppressive ART. HIV-1 CA-RNA copies were measured using the highly sensitive Double-R assay and normalized /106 CD4+ T cells. 18-colour flow cytometry was used to count and analyse CD4+ T cells and monocytes in CSF and blood. The concentrations of major brain metabolites from 1H MRS in frontal white matter (FWM), posterior cingulate cortex (PCC), and caudate areas were measured. Brain injury in each voxel was defined using a composite score derived by principal component analysis.

Results

14/16 CSF cell samples had quantifiable HIV-1 CA-RNA transcripts, at levels significantly higher than in their PBMCs (median 9,266 vs 185 copies /106 CD4+ T cells; p<0.0001). Higher levels of CSF transcripts were associated with greater brain injury in the FWM (Std β=-0.73; p=0.007) and PCC (Std β=-0.61; p=0.03). CSF cells were 91% memory T cells, equally CD4+ (median 3,605) cells and CD8+ T cells (3,632), but contained much fewer B cells (0.4 %), NK cells (2.0%) and monocytes (3.1%; 378 cells; >90% CD14+CD16+ phenotype). CXCR3+CD49d+integrin ß7-negative, CCR5+ CD4+ T cells were significantly enriched in CSF, compared with PBMC (p <0.001). Transcriptional activity in CSF cells was highly correlated with levels of transcriptional activity in CD4+ T cells in PBMC (r=0.76; p=0.002). In contrast, HIV-1 RNA in highly purified monocytes from PBMC was detected in only 6/16 samples.

Conclusions

Elevated HIV-1 transcripts in CSF cells were associated with in vivo brain injury, despite suppressive ART. The cellular source is most likely the predominant CXCR3+ CD49d+ integrinß7-CCR5+ memory CD4+ T cells, not monocytes. Inhibitors of transcription to reduce local production of potentially neurotoxic proteins, should be developed.
Early estimates of SARS-CoV-2 Omicron variant severity based on a matched cohort study, Ontario, Canada
Authors: Ulloa Ana Cecilia , Buchan Sarah A. , Daneman Nick , Brown Kevin A
Published: December 2021

While it is now evident that Omicron is rapidly replacing Delta, largely due to immune escape, it is less clear how the severity of Omicron compares to Delta. In Ontario, we sought to examine hospitalization and death associated with Omicron, as compared to cases infected with Delta. We conducted a matched cohort study, considering time to hospitalization or death as the outcome. Cases were matched on gender, age, vaccination status, health region and onset date. We identified 29,594 Omicron cases that met eligibility criteria, of which 11,622 could be matched with at least one Delta case (N=14,181). There were 59 (0.51%) hospitalizations and 3 (0.03%) deaths among matched Omicron cases, compared to 221 (1.6%) hospitalizations and 17 (0.12%) deaths among matched Delta cases. The risk of hospitalization or death was 65% lower (hazard ratio, HR=0.35, 95%CI: 0.26, 0.46) among Omicron cases compared to Delta cases, while risk of intensive care unit admission or death was 83% lower (HR=0.17, 95%CI: 0.08, 0.37). While severity is likely to be reduced, the absolute number of hospitalizations and impact on the healthcare system may nevertheless be significant due to the increased transmissibility of Omicron.
Associations of mitochondrial DNA copy number with incident risks of gastrointestinal cancers: a prospective case-cohort study
Authors: Guan Xin , Li Mengying , Bai Yansen , Feng Yue , Li Guyanan , Wei Wei , Fu Ming , Li Hang , Wang Chenming , Jie Jiali , Meng Hua , Wu Xiulong , Deng Qilin , Li Fangqing , Yang Handong , Zhang Xiaomin , He Meian , Guo Huan
Published: December 2021

Background

Epidemiological investigations implied that inter-individual variations of mitochondrial DNA copy number (mtDNAcn) could trigger predisposition to multiple cancers, but evidence regarding gastrointestinal cancers (GICs) was still uncertain.

Methods

We conducted a case-cohort study within the prospective Dongfeng-Tongji cohort, including incident cases of colorectal cancer (CRC, n=278), gastric cancer (GC, n=138), and esophageal cancer (EC, n=72) as well as a random subcohort (n=1173), who were followed up from baseline to the end of 2018. Baseline blood mtDNAcn was determined with quantitative PCR assay, and associations of mtDNAcn with the GICs risks were estimated by using weighted Cox proportional hazards models.

Results

Significant U-shaped associations were observed between mtDNAcn and risks of CRC, GC, EC, and total GICs. Compared to subjects within the 2nd quartile (Q2) mtDNAcn subgroup, those within the 1st (Q1), 3rd (Q3) and 4th (Q4) quartile subgroups showed increased risks of CRC [HR(95%CI)=2.27(1.47-3.52), 1.65(1.04-2.62), and 2.81(1.85-4.28), respectively] and total GICs [HR(95%CI)=1.84(1.30-2.60), 1.47(1.03-2.10), and 2.51(1.82-3.47), respectively], and those within Q4 subgroup present elevated GC and EC risks [HR(95%CI)=2.16(1.31-3.54) and 2.38(1.13-5.02), respectively]. Similar associations of mtDNAcn with CRC and total GICs risks remained in stratified analyzes by age, gender, and smoking status. Notably, there were joint effects of age and smoking status with mtDNAcn on CRC and total GICs risks.

Conclusions

This prospectively case-cohort study showed U-shaped associations between mtDNAcn and incident risks of GICs, but further researches are needed to confirm these results and uncover underlying biological mechanisms.
Comparative analysis of single cell lung atlas of bat, cat, tiger and pangolin
Authors: Wang Xiran , Ou Zhihua , Ding Peiwen , Sun Chengcheng , Wang Daxi , Zhu Jiacheng , Wu Wendi , Wei Yanan , Ding Xiangning , Luo Lihua , Li Meiling , Zhang Wensheng , Jin Xin , Sun Jian , Liu Huan , Chen Dongsheng
Published: December 2021

Horseshoe bats (Rhinolophus sinicus) might help maintain coronaviruses severely affecting human health, such as SARS-CoV and SARS-CoV-2. It has long been suggested that bats may be more tolerant of viral infection than other mammals due to their unique immune system, but the exact mechanism remains to be fully explored. During the COVID-19 pandemic, multiple animal species were diseased by SARS-CoV-2 infection, especially in the respiratory system. Herein, single-cell transcriptomic data of the lungs of a horseshoe bat, a cat, a tiger, and a pangolin were generated. The receptor distribution of twenty-eight respiratory viruses belonging to fourteen viral families were characterized for the four species. Comparison on the immune-related transcripts further revealed limited cytokine activations in bats, which might explain the reason why bats experienced only mild diseases or even no symptoms upon virus infection. Our findings might increase our understanding of the immune background of horseshoe bats and their insensitivity to virus infections.