bluuebunny/crossref_metadata_2025 huggingface dataset:
CYSTIC FIBROSIS IN AN ADULT – A RARE CASE – DIAGNOSED AND CONFIRMED BY A NEW, NOVEL, INDIGENOUS TECHNIQUE
Authors: Sharma Raghava , Raj Raghu , Shetty Sukanya
Published: April 2020

Cystic fibrosis (CF) is an important autosomal recessive disorder caused due to genetic mutation thus affecting the chloride channel. It involves multiple systems particularly lungs, respiratory tract and gastro intestinal tract. It is mainly considered as a disease of pediatric population. However it is being reported from adult population, more frequently from the western countries due to better survival.

CF is reported very rarely from India and report of adult CF is much more rarer. Conformation of CF is by HRCT (High resolution computerized tomography), gene mutation analysis and sweat chloride estimation. However sweat chloride test presently being employed (called pilocarpine iontophoresis ) is costly, very complicated and is not available even in most advanced centers in India.

Our case highlights the need for a high index of suspicion for suspecting CF in adults with chronic respiratory symptoms, and the need for a cost effective, easily available, reproducible, standardized test technique for sweat chloride estimation.

Here with we present a case of CF (cystic fibrosis) in an adult male of 23 years whose diagnosis was confirmed by a new novel indigenous technique of Sweat chloride estimation.
NURSING INFORMATICS
Authors: Ponchitra R.
Published: April 2020

Computers have opened for us a world of information. New and emerging technologies will continue to have an effect on the health care delivery system. Nurses as a major player in health care, will be part of this ever growing era technology. A nurse must know generalized applications such as word processing, as well as specialized applications such as clinical information system. Virtual reality (simulation) and ubiquitous(every where) computing are emerging and being used in education and other areas in health care nursing knowledge workers must be able to understand the evolving specialty, nursing informatics, in order to begin to harness and use the tools available for managing the vast amount of health care data and information. This article mentions in detail about Nursing Informatics and therefore highlights that nursing informatics capabilities be appreciated, promoted, expanded and advanced to facilitate the work of the Nurse, improve patient care, and enhance the Nursing profession.
BUTT AND HIT - THE HEART KIDNEY SAGA: A SNAP SHOT AND LONG TERM PERSPECTIVES
Authors: Sharma Raghava , Shetty Shashank
Published: April 2020

Tobacco smoking is an universal problem. There are about 120 million smokers in India in the age group of 30-69 years and have an increased cardiovascular and renal risks in addition to other risks attributable to smoking..

The present study was aimed to assess the cardiovascular and renal risks especially among the young smokers in the age group of 20-40 years. After all necessary administrative and ethical clearances a cross sectional study was conducted at the tertiary care medical college hospital located at Mangalore. 75 young male smokers in the age group of 20-40 years along with equal number of age, sex matched non smokers as controls were recruited and each one were assessed for Blood pressure(BP), Electro cardiographic changes(ECG changes), and Glomerular filtration rate(GFR).

In the present study Smoking resulted in high systolic blood pressure and prolonged QT interval (QTc) as compared to the non smokers, thus increasing the risk of Sudden cardiac death among smokers. Longer duration of smoking of more than 10 years resulted in Pre hypertension and reduced GFR in comparison to smokers with lesser duration of smoking of less than 10 years.

This study highlights the need to tackle “Smoking” among young adults more aggressively to avoid the potential cardiovascular and renal complications, as Tobacco smoking is a major modifiable risk factor for the same.
GENDER DIFFERENCES IN CHILDHOOD POISONING
Authors: Tarvadi Pratik Vijay , Bakkannavar Shankar M. , Palimar Vikram , Kumar G. Pradeep , Shetty Mahabalesh , Badiger Sanjeev
Published: April 2020

Background: Accidental paediatric poisoning is a common medical emergency and also associated with a high morbidity and mortality in children. In developing countries like India, the poisoning emergencies are becoming a major cause of mortality in infants and toddlers. Among the various studies done on poisoning cases in our country, the study on poisoning is more or less only on adults and hence this study is taken up to understand the number of childhood poisoning cases (based on gender).

Method: A ten year record based cross sectional study from January 1999 to December 2008 was conducted at the Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, to understand the magnitude of childhood poisoning cases among males and females at Kasturba Hospital, Manipal.

Results: Male children were predominantly affected (male: female::1.32: 1). Most of the poisoning cases occurred at home in both the genders with boy to girl ratio based on percentage in indoor poisoning being 0.92:1 and boy to girl ratio based on percentage in outcome being 1.06:1.

Conclusion: Our study examines the difference in place and outcome of poisoning among boys and girls to identify population at risk and give suggestions so as to reduce the morbidity and mortality.
A COMPARATIVE STUDY ON COPING STRATEGIES AND SENSE OF COHERENCE AMONG CAREGIVERS OF MENTALLY AND NEUROLOGICALLY ILL PATIENTS IN KASTURBA HOSPITAL, MANIPAL, KARNATAKA
Authors: George Rigi , Nayak Asha , D'Souza Anjalin
Published: April 2020

Introduction: Diseases take a toll not only on those affected, but also on the ones around them. Regardless of language, culture or country caregiving has become an everyday part of life for millions of people around the globe. Though differently named on each continent, these millions of 'carers' or 'caregivers' provide care to family members, partners or friends each year because they are sick, elderly or have a disability. This cross-sectional study was undertaken to assess the coping strategies and sense of coherence among caregivers of patients with mental and neurologic illness.

Methods: Comparative, descriptive study design was used. The study was conducted among 40 caregivers of clients who were admitted in psychiatric and neurologic wards of Kasturba Hospital, Manipal. Tools used were demographic proforma, coping scale and sense of coherence-29 scale.

Results: Findings showed that there was no significant difference in the coping strategies and sense of coherence of caregivers of mentally and neurologically ill patients (p>0.05). The study also revealed that there was no association between sense of coherence and coping strategies of caregivers of mentally ill patients (p=1).

Conclusion: Both the caregivers of mentally and neurologically ill patients used almost same coping strategies such as substance abuse and denial. Both the caregivers of mentally and neurologically ill patients considered caring their relative during illness is meaningful. The study highlights the need for family interventional programs to address the specific concern, related to coping and sense of coherence of caregivers.
Cystic Pancreatic Lesions: A Review of Diagnosis and Management
Authors: Le Ott , Rovira Juan J. Ibarra
Published: April 2020

Pancreatic cysts are commonly seen with increasing use of cross-sectional imaging. They range from a benign inflammatory process that can produce pseudocysts to malignant lesions such as mucinous cystadenocarcinoma. Other common pancreatic cysts include intraductal pancreatic mucinous neoplasms and serous cystadenomas. Optimized imaging protocol dedicated to imaging the pancreas is required, such as multiphasic computed tomography, magnetic resonance imaging/magnetic resonance cholangiopancreatography, or endoscopic ultrasound, to fully detect and characterize the lesions. A confident diagnosis can be made on imaging when features such as calcifications, pancreatic duct diameter, main duct communication, and mural nodules are assessed. Additionally, pathologic evaluation from fluid/tissue sampling aid in diagnosis. Optimal management of pancreatic cysts is achieved based on the imaging features, conveying key findings in the radiology report, pathologic evaluation, and clinical factors.
Plattformen im Krankenhauseinkauf: Wo stehen wir im Jahr 2020?
Authors: Merkel Martin
Published: April 2020

Moderne Plattformlösungen sind auf dem Vormarsch! Die Möglichkeiten scheinen unbegrenzt, jedoch sollte man sich die Anwendungsfälle genau anschauen. Was im niedergelassenen Bereich Standard ist, muss noch lange nicht für den Klinikmarkt zutreffen. Zudem gibt es ständig wechselnde Normen und Validierungsregeln. Ein Status Quo soll Licht ins Dunkle bringen und die aktuellen Herausforderungen und Lösungsansätze skizzieren.
Better together? Explaining Poland’s and Germany’s bargaining success in EU lawmaking
Authors: Kirpsza Adam
Published: April 2020

The article seeks to explain the bargaining success of Poland and Germany in EU lawmaking. Specifically, it explores how the similarity of Poland’s and Germany’s preferences affects their bargaining success and whether it is more beneficial than their proximity to other member states holding the highest voting power. The analysis conducted on the DEUII dataset leads to three conclusions. First, there is a strong discrepancy between Poland’s and Germany’s preferences. Second, despite having divergent preferences, both Poland and Germany are more successful when they approximate or hold similar positions on EU legislation. Importantly, this relationship is robust to the extremity of their preferences, the status quo position, their closeness to the Parliament and Commission, the proposal’s multidimensionality, procedure or policy area. Third, bringing preferences closer provides both Poland and Germany with higher success than moving their policy positions towards other pivotal member states, namely France, the UK (except for Poland), Italy and Spain. Overall, the paper demonstrates that mutual cooperation (i.e. the approximation or exchange of preferences) is extremely profitable for Poland and Germany as their success is strongly dependent on the level of similarity of their preferences, irrespective of other negotiating conditions and relations with pivotal actors.
Trace formulas for the Casimir operators of the unextended Schrödinger algebra S(N)
Authors: Campoamor-Stursberg R.
Published: April 2020

Using the contraction of the centrally extended Schrödinger algebra S^(N) onto the Lie algebra S(N)⊕R in combination with the Newton identities associated with the characteristic polynomial of a matrix, we derive explicit expressions for the Casimir operators of the unextended Schrödinger algebra S(N) in terms of trace operators. It is shown that these operators can be defined independently of the contraction from which a direct method for the computation of the S(N)-invariants is deduced.
A microplasma process for hexagonal boron nitride thin film synthesis
Authors: Kabbara H. , Kasri S. , Brinza O. , Bauville G. , Gazeli K. , Santos Sousa J. , Mille V. , Tallaire A. , Lombardi G. , Lazzaroni C.
Published: April 2020

A process based on microplasmas generated in Ar/N2 mixtures for nanomaterial synthesis is described in this Letter. The targeted material is hexagonal boron nitride (h-BN) that is in high demand for electronic and optoelectronic applications. The synthesis of high crystalline quality h-BN films over large areas still remains a challenge. In this study, a nanosecond pulsed high voltage is applied between two electrodes separated by a dielectric layer, with the whole system being drilled by a 400 μm diameter hole (micro hollow cathode structure). This geometry allows for an efficient dissociation of N2 gas, a particularly important asset for the synthesis of nitride materials, which normally requires very high deposition temperatures (∼1300 °C). In this work, we report the growth of h-BN on 2-in. silicon substrates at temperatures below 1000 °C, with a growth rate of about 30 nm/h, using this approach. The deposited films are characterized by Raman and electron energy loss spectroscopies and transmission electron microscopy to evaluate the phase purity, the quality, the surface morphology, and the crystallinity of the material. The films exhibit a stoichiometry very close to 1 with a crystalline domain size of about 3 nm.
NbTiN thin films for superconducting photon detectors on photonic and two-dimensional materials
Authors: Steinhauer Stephan , Yang Lily , Gyger Samuel , Lettner Thomas , Errando-Herranz Carlos , Jöns Klaus D. , Baghban Mohammad Amin , Gallo Katia , Zichi Julien , Zwiller Val
Published: April 2020

Integration of superconducting devices on photonic platforms opens up a wide range of functionalities and applications. We report on NbTiN thin films deposited on SiO2, Si3N4, GaAs, LiNbO3, and AlN as well as on a monolayer of hexagonal boron nitride, using a universal reactive co-sputtering recipe. The morphology and the superconducting properties of the NbTiN thin films with a thickness of 10 nm were characterized by atomic force microscopy and electrical transport measurements. Superconducting strip photon detectors were fabricated using a design suitable for waveguide integration and compared in terms of their internal quantum efficiency and detection pulse kinetics. Our results show well-comparable performances for detectors integrated on different platforms, while also demonstrating that reactive co-sputter deposition of NbTiN at room temperature provides a robust method for realizing superconducting devices on various materials.
Intermolecular forces and correlations mediated by a phonon bath
Authors: Li Xiang , Yakaboylu Enderalp , Bighin Giacomo , Schmidt Richard , Lemeshko Mikhail , Deuchert Andreas
Published: April 2020

Inspired by the possibility to experimentally manipulate and enhance chemical reactivity in helium nanodroplets, we investigate the effective interaction and the resulting correlations between two diatomic molecules immersed in a bath of bosons. By analogy with the bipolaron, we introduce the biangulon quasiparticle describing two rotating molecules that align with respect to each other due to the effective attractive interaction mediated by the excitations of the bath. We study this system in different parameter regimes and apply several theoretical approaches to describe its properties. Using a Born–Oppenheimer approximation, we investigate the dependence of the effective intermolecular interaction on the rotational state of the two molecules. In the strong-coupling regime, a product-state ansatz shows that the molecules tend to have a strong alignment in the ground state. To investigate the system in the weak-coupling regime, we apply a one-phonon excitation variational ansatz, which allows us to access the energy spectrum. In comparison to the angulon quasiparticle, the biangulon shows shifted angulon instabilities and an additional spectral instability, where resonant angular momentum transfer between the molecules and the bath takes place. These features are proposed as an experimentally observable signature for the formation of the biangulon quasiparticle. Finally, by using products of single angulon and bare impurity wave functions as basis states, we introduce a diagonalization scheme that allows us to describe the transition from two separated angulons to a biangulon as a function of the distance between the two molecules.
Numerical simulations of an inverted flexible plate in linear shear flows
Authors: Wang Lei , Fang Zhen , Hua Ru-Nan , Peng Ze-Rui
Published: April 2020

In this paper, the interaction between an elastic plate and viscous fluids is numerically studied through a coupling lattice Boltzmann method with a finite element method. In simulations, the plate, which has a clamped trailing edge, is immersed in a linear shear flow of relatively low Reynolds numbers (Re). The dynamical analysis has been conducted in terms of aspect ratio (H), Reynolds number (Re), stiffness coefficient (K), and attack angle (β). Four generic modes for the plate motion or deformation are identified, and the respective characteristics are shown. Three maps of mode distributions depending on K, H, Re, and β are given definitely. Three routes for the plate to reach the deflected mode have been found. The elastic potential energy under different K numbers and aspect ratios H is compared. It is indicated that the larger aspect ratio would result in larger efficiency of energy transformation. It is also found that the flapping mode can only occur when the attack angle β ≥ 0°, i.e., if β < 0°, the plate merely remains in the deflected or straight mode. The vortex structures and the pressure distributions are shown clearly for flapping and deflected modes of the plate. The present results can provide useful information to the physical understanding of the dynamics for the plate motion in shear flows and can also offer additional knowledge about a flexible plate using energy from ambient fluids.
Electrically detected magnetic resonance study on interface defects at nitrided Si-face, a-face, and m-face 4H-SiC/SiO2 interfaces
Authors: Higa E. , Sometani M. , Hirai H. , Yano H. , Harada S. , Umeda T.
Published: April 2020

We investigated interface defects formed on a-face and m-face 4H-SiC/SiO2 interfaces after interface nitridation by nitric oxide (NO) post-oxidation annealing (POA). Using electrically detected magnetic-resonance spectroscopy, we observed interface defects on these faces. The a- and m-face interface defects were found to be similar to a carbon-related interface defect (the PbC center) observed on the standard Si-face, but their amounts were significantly lower than those of the Si-face after the same NO POA. Such a reduction was correlated with a drastic increase in the field-effect mobility (80–90 cm2 V−1 s−1) of the a- and m-face metal-oxide-semiconductor field-effect transistors after NO POA. We also found that over-nitridation caused the formation of two types of nitrogen-related defects on the Si-face. These nitrogen-related defects resemble the K center (Si dangling-bond center) observed in Si3N4.
A GaN/AlN quantum cascade detector with a broad response from the mid-infrared (4.1
μ
m) to the visible (550 nm) spectral range
Authors: Quach P. , Liu S. F. , Jollivet A. , Wang D. , Cheng J. Y. , Isac N. , Pirotta S. , Bouville D. , Sheng S. S. , Imran A. , Chen L. , Li D. , Zheng X. T. , Wang Y. X. , Qin Z. X. , Tchernycheva M. , Julien F. H. , Shen B. , Wang X. Q.
Published: April 2020

We report on a GaN/AlN quantum cascade detector operating in an extended spectral range going from the mid-infrared to visible wavelengths. This broadband detection is achieved thanks to the design of active quantum wells supporting five bound-to-bound intersubband transitions. The photodetector exhibits a broad signal between 4.1 μm and 550 nm. The photocurrent persists up to room temperature. The calibrated responsivity at 77 K under irradiation through a 45° angle polished facet amounts to 7 μA/W at a wavelength of 633 nm and is peaked at 14 μA/W at a wavelength of 720 nm.
Holomorphic quantum Hall states in higher Landau levels
Authors: Rougerie Nicolas , Yngvason Jakob
Published: April 2020

Eigenstates of the planar magnetic Laplacian with a homogeneous magnetic field form degenerate energy bands, the Landau levels. We discuss the unitary correspondence between states in higher Landau levels and those in the lowest Landau level, where wave functions are holomorphic. We apply this correspondence to many-body systems; in particular, we represent effective Hamiltonians and particle densities in higher Landau levels by using corresponding quantities in the lowest Landau level.
Study of single-layer stacking faults in 4H–SiC by deep level transient spectroscopy
Authors: Feklisova O. V. , Yakimov E. E. , Yakimov E. B.
Published: April 2020

The electronic properties of single-layer Shockley-type stacking faults (SSFs) in 4H–SiC have been studied by deep level transient spectroscopy (DLTS) in the temperature range from 80 to 300 K. SSFs are introduced by low energy electron beam irradiation at room temperature using intentionally made scratches as nucleation sites. A DLTS peak was detected after SSF nucleation and expansion, the amplitude of which decreases after SSF shrinking. For the SSF energy level, a value of 0.213 ± 0.005 eV below the conduction band minimum is obtained, which well correlates with theoretical predictions.
Phonon softening in sodium with a stepwise electron distribution
Authors: Ono Shota , Kobayashi Daigo
Published: April 2020

The absorption of light by a metal disturbs the electron distribution around the Fermi surface. Here, we calculate the phonon dispersion relations of free-electron-like metal, bcc sodium, with a stepwise electron distribution function by using a model potential. The step can behave as a pseudo-Fermi surface, which produces singularities at specific wave numbers in the response function. The singularity gives rise to long-range oscillations in the interatomic potential and results in phonon softening along the Γ–N direction. The effect of the smearing in the step function is also discussed.
Tuning the carrier density in SrTiO3/LaTiO3/SrTiO3 quantum wells
Authors: Lee J. N. , Hou X. , Takahashi R. , Lippmaa M.
Published: April 2020

We discuss methods of built-in carrier density control in SrTiO3/LaTiO3/SrTiO3 heterostructures that exhibit quasi-two-dimensional carrier confinement in an interfacial quantum well. Unlike the electronically similar LaAlO3/SrTiO3 heterostructures, where the polar discontinuity at the interface defines the accumulated carrier density, the LaTiO3 heterostructures offer two means of carrier density control—changing the La doping level and utilizing the effect of surface depletion through the change in the SrTiO3 capping layer thickness. Dynamic carrier tuning over a limited range is possible by the application of a back-gate bias, which primarily affects the depth distribution of carriers. We find that small changes in the pre-annealing conditions of a SrTiO3 substrate can have a dramatic effect on the low-temperature sheet resistance of the heterostructures.
Algorithmic cooling of nuclear spins using long-lived singlet order
Authors: Rodin Bogdan A. , Bengs Christian , Kiryutin Alexey S. , Sheberstov Kirill F. , Brown Lynda J. , Brown Richard C. D. , Yurkovskaya Alexandra V. , Ivanov Konstantin L. , Levitt Malcolm H.
Published: April 2020

Algorithmic cooling methods manipulate an open quantum system in order to lower its temperature below that of the environment. We achieve significant cooling of an ensemble of nuclear spin-pair systems by exploiting the long-lived nuclear singlet state, which is an antisymmetric quantum superposition of the “up” and “down” Zeeman states. The effect is demonstrated by nuclear magnetic resonance experiments on a molecular system containing a coupled pair of near-equivalent 13C nuclei. The populations of the system are subjected to a repeating sequence of cyclic permutations separated by relaxation intervals. The long-lived nuclear singlet order is pumped well beyond the unitary limit. The pumped singlet order is converted into nuclear magnetization which is enhanced by 21% relative to its thermal equilibrium value.
Effective treatment of severe COVID-19 patients with tocilizumab
Authors: Xu Xiaoling , Han Mingfeng , Li Tiantian , Sun Wei , Wang Dongsheng , Fu Binqing , Zhou Yonggang , Zheng Xiaohu , Yang Yun , Li Xiuyong , Zhang Xiaohua , Pan Aijun , Wei Haiming
Published: April 2020

Significance

In patients with coronavirus disease 2019, a large number of T lymphocytes and mononuclear macrophages are activated, producing cytokines such as interleukin-6 (IL-6), which bind to the IL-6 receptor on the target cells, causing the cytokine storm and severe inflammatory responses in lungs and other tissues and organs. Tocilizumab, as a recombinant humanized anti-human IL-6 receptor monoclonal antibody, can bind to the IL-6 receptor with high affinity, thus preventing IL-6 itself from binding to its receptor, rendering it incapable of immune damage to target cells, and alleviating the inflammatory responses.
P120catenin tuning of VE-cadherin endocytosis controls collective cell behavior during angiogenesis
Authors: Etienne-Manneville Sandrine
Published: April 2020

How cells can stick together while moving through a complex environment is not fully understood. In this issue, Grimsley-Myers et al. (2020. J. Cell Biol.https://doi.org/10.1083/jcb.201909081) demonstrate that, in the case of blood vessel formation, the balance between the maintenance of endothelial integrity and the dynamics of cell-cell contacts required for collective migration relies on VE-cadherin endocytosis.
A firehose for phospholipids
Authors: Prinz William A. , Hurley James H.
Published: April 2020

All lipid transport proteins in eukaryotes are thought to shuttle lipids between cellular membranes. In this issue, Li et al. (2020. J. Cell Biol.https://doi.org/10.1083/jcb.202001161) show that Vps13 has a channel-like domain that may allow lipids to flow between closely apposed membranes at contact sites.
The action of a BK channel opener
Authors: Cui Jianmin
Published: April 2020

Rockman et al. in this issue of JGP describe how NS11021 opens BK channels, which make the compound a better tool to probe physiological roles and gating mechanisms of BK channels.
Precision Health: The Role of the Social and Behavioral Sciences in Advancing the Vision
Authors: Hekler Eric , Tiro Jasmin A , Hunter Christine M , Nebeker Camille
Published: April 2020

Background

In 2015, Collins and Varmus articulated a vision for precision medicine emphasizing molecular characterization of illness to identify actionable biomarkers to support individualized treatment. Researchers have argued for a broader conceptualization, precision health. Precision health is an ambitious conceptualization of health, which includes dynamic linkages between research and practice as well as medicine, population health, and public health. The goal is a unified approach to match a full range of promotion, prevention, diagnostic, and treatment interventions to fundamental and actionable determinants of health; to not just address symptoms, but to directly target genetic, biological, environmental, and social and behavioral determinants of health.

Purpose

The purpose of this paper is to elucidate the role of social and behavioral sciences within precision health.

Main body

Recent technologies, research frameworks, and methods are enabling new approaches to measure, intervene, and conduct social and behavioral science research. These approaches support three opportunities in precision health that the social and behavioral sciences could colead including: (a) developing interventions that continuously “tune” to each person’s evolving needs; (b) enhancing and accelerating links between research and practice; and (c) studying mechanisms of change in real-world contexts. There are three challenges for precision health: (a) methods of knowledge organization and curation; (b) ethical conduct of research; and (c) equitable implementation of precision health.

Conclusions

Precision health requires active coleadership from social and behavioral scientists. Prior work and evidence firmly demonstrate why the social and behavioral sciences should colead with regard to three opportunity and three challenge areas.
The role of illness acuity on the association between frailty and mortality in emergency department patients referred to internal medicine
Authors: Pulok Mohammad Habibullah , Theou Olga , van der Valk Alexandra M , Rockwood Kenneth
Published: April 2020

Background

we investigated whether two frailty tools predicted mortality among emergency department (ED) patients referred to internal medicine and how the level of illness acuity influenced any association between frailty and mortality.

Methods

two tools, embedded in a Comprehensive Geriatric Assessment (CGA), were the clinical frailty scale (CFS) and a 57-item deficit accumulation frailty index (FI-CGA). Illness acuity was assessed using the Canadian Triage and Acuity Scale (CTAS). We examined all-cause 30-day and 6-month mortality and time to death.

Results

in 808 ED patients (mean age ± SD 80.8 ± 8.8, 54.4% female), the mean FI-CGA score was 0.44 ± 0.14, and the CFS was 5.6 ± 1.6. A minority (307; 38%) were classified as having high acuity (CTAS: 1–2). The 30-day mortality rate was 17%; this increased to 34% at 6 months. Compared to well patients with low acuity, the risk of 30-day mortality was 22.5 times (95% CI: 9.35–62.12) higher for severely frail patients with high acuity; 53% of people with very severe frailty (CFS = 8) and high acuity died within 30 days. When acuity was low, the risk for 30-day mortality was significantly higher only among those with very high levels of frailty (CFS 7–9, FI-CGA > 0.5). When acuity was high, even lower levels of frailty (CFS 5–6, FI-CGA 0.4–0.5) were associated with higher 30-day mortality.

Conclusions

across levels of frailty, higher acuity increased mortality risk. When acuity was low, the risk was significant only when the degree of frailty was high, whereas when acuity was high, even lower levels of frailty were associated with greater mortality risk.
Safety of intravenous push administration of beta-lactams within a healthcare system
Authors: Marsh Kassandra , Ahmed Nabeela , Decano Arnold , Dubrovskaya Yanina , Jen Shin-Pung (Polly) , Siegfried Justin , Chen Xian Jie (Cindy) , Merchan Cristian
Published: April 2020

Purpose

A critical shortage of small-volume parenteral solutions in late 2017 led hospitals to develop strategies to ensure availability for critical patients, including administration of antibiotics as intravenous push (IVP). Minimal literature has been published to date that assesses the safety of administration of beta-lactams via this route. Therefore, the purpose of this study was to evaluate the safety of IVP administration of select beta-lactam antibiotics.

Methods

We performed a retrospective review of IVP administrations of aztreonam, ceftriaxone, cefepime, and meropenem at two campuses of the New York University Langone Health system after October 2017. Patients receiving surgical prophylaxis or more than one IVP antibiotic simultaneously were excluded. The primary endpoint was adverse events (ADE) following IVP administration of antibiotics.

Results

We evaluated 1000 patients who received IVP aztreonam (n = 43), ceftriaxone (n = 544), cefepime (n = 368) or meropenem (n = 45). There were 10 (1%) ADE observed, 5 of which were allergic reactions. Four ADE were neurotoxicity related to IVP cefepime. Based on the Naranjo score, 1 adverse event was “probably” and 3 were “possibly” related to cefepime IVP administration. Lastly, only 1 report of phlebitis was observed with the use of IVP ceftriaxone.

Conclusions

The use of IVP as an alternative to intravenous piggyback (IVPB) during times of drug shortage for select beta-lactam antibiotics appears to be safe, and ADE are similar to those previously described for IVPB administration. Future studies evaluating clinical outcomes between IVP and IVPB administration may be of benefit.
Bayesian structural equation modeling in multiple omics data with application to circadian genes
Authors: Maity Arnab Kumar , Lee Sang Chan , Mallick Bani K , Sarkar Tapasree Roy
Published: April 2020

Motivation

It is well known that the integration among different data-sources is reliable because of its potential of unveiling new functionalities of the genomic expressions, which might be dormant in a single-source analysis. Moreover, different studies have justified the more powerful analyses of multi-platform data. Toward this, in this study, we consider the circadian genes’ omics profile, such as copy number changes and RNA-sequence data along with their survival response. We develop a Bayesian structural equation modeling coupled with linear regressions and log normal accelerated failure-time regression to integrate the information between these two platforms to predict the survival of the subjects. We place conjugate priors on the regression parameters and derive the Gibbs sampler using the conditional distributions of them.

Results

Our extensive simulation study shows that the integrative model provides a better fit to the data than its closest competitor. The analyses of glioblastoma cancer data and the breast cancer data from TCGA, the largest genomics and transcriptomics database, support our findings.

Availability and implementation

The developed method is wrapped in R package available at https://github.com/MAITYA02/semmcmc.

Supplementary information

Supplementary data are available at Bioinformatics online.
pepFunk: a tool for peptide-centric functional analysis of metaproteomic human gut microbiome studies
Authors: Simopoulos Caitlin M A , Ning Zhibin , Zhang Xu , Li Leyuan , Walker Krystal , Lavallée-Adam Mathieu , Figeys Daniel
Published: April 2020

Motivation

Enzymatic digestion of proteins before mass spectrometry analysis is a key process in metaproteomic workflows. Canonical metaproteomic data processing pipelines typically involve matching spectra produced by the mass spectrometer to a theoretical spectra database, followed by matching the identified peptides back to parent-proteins. However, the nature of enzymatic digestion produces peptides that can be found in multiple proteins due to conservation or chance, presenting difficulties with protein and functional assignment.

Results

To combat this challenge, we developed pepFunk, a peptide-centric metaproteomic workflow focused on the analysis of human gut microbiome samples. Our workflow includes a curated peptide database annotated with Kyoto Encyclopedia of Genes and Genomes (KEGG) terms and a gene set variation analysis-inspired pathway enrichment adapted for peptide-level data. Analysis using our peptide-centric workflow is fast and highly correlated to a protein-centric analysis, and can identify more enriched KEGG pathways than analysis using protein-level data. Our workflow is open source and available as a web application or source code to be run locally.

Availability and implementation

pepFunk is available online as a web application at https://shiny.imetalab.ca/pepFunk/ with open-source code available from https://github.com/northomics/pepFunk.

Contact

dfigeys@uottawa.ca

Supplementary information

Supplementary data are available at Bioinformatics online.
GM-DockZn: a geometry matching-based docking algorithm for zinc proteins
Authors: Wang Kai , Lyu Nan , Diao Hongjuan , Jin Shujuan , Zeng Tao , Zhou Yaoqi , Wu Ruibo
Published: April 2020

Motivation

Molecular docking is a widely used technique for large-scale virtual screening of the interactions between small-molecule ligands and their target proteins. However, docking methods often perform poorly for metalloproteins due to additional complexity from the three-way interactions among amino-acid residues, metal ions and ligands. This is a significant problem because zinc proteins alone comprise about 10% of all available protein structures in the protein databank. Here, we developed GM-DockZn that is dedicated for ligand docking to zinc proteins. Unlike the existing docking methods developed specifically for zinc proteins, GM-DockZn samples ligand conformations directly using a geometric grid around the ideal zinc-coordination positions of seven discovered coordination motifs, which were found from the survey of known zinc proteins complexed with a single ligand.

Results

GM-DockZn has the best performance in sampling near-native poses with correct coordination atoms and numbers within the top 50 and top 10 predictions when compared to several state-of-the-art techniques. This is true not only for a non-redundant dataset of zinc proteins but also for a homolog set of different ligand and zinc-coordination systems for the same zinc proteins. Similar superior performance of GM-DockZn for near-native-pose sampling was also observed for docking to apo-structures and cross-docking between different ligand complex structures of the same protein. The highest success rate for sampling nearest near-native poses within top 5 and top 1 was achieved by combining GM-DockZn for conformational sampling with GOLD for ranking. The proposed geometry-based sampling technique will be useful for ligand docking to other metalloproteins.

Availability and implementation

GM-DockZn is freely available at www.qmclab.com/ for academic users.

Supplementary information

Supplementary data are available at Bioinformatics online.
The Current Status of Enteric Fever Diagnostics and Implications for Disease Control
Authors: Baker Stephen , Blohmke Christoph J , Maes Mailis , Johnston Peter I , Darton Thomas C
Published: April 2020

Enteric (typhoid) fever remains a problem in low- and middle-income countries that lack the infrastructure to maintain sanitation and where inadequate diagnostic methods have restricted our ability to identify and control the disease more effectively. As we move into a period of potential disease elimination through the introduction of typhoid conjugate vaccine (TCV), we again need to reconsider the role of typhoid diagnostics in how they can aid in facilitating disease control. Recent technological advances, including serology, transcriptomics, and metabolomics, have provided new insights into how we can detect signatures of invasive Salmonella organisms interacting with the host during infection. Many of these new techniques exhibit potential that could be further explored with the aim of creating a new enteric fever diagnostic to work in conjunction with TCV. We need a sustained effort within the enteric fever field to accelerate, validate, and ultimately introduce 1 (or more) of these methods to facilitate the disease control initiative. The window of opportunity is still open, but we need to recognize the need for communication with other research areas and commercial organizations to assist in the progression of these diagnostic approaches. The elimination of enteric fever is now becoming a real possibility, but new diagnostics need to be part of the equation and factored into future calculations for disease control.
Predictors of Discordant Tuberculin Skin Test and QuantiFERON-TB Gold In-tube Results in Eastern China: A Population-based, Cohort Study
Authors: Lu Peng , Liu Qiao , Zhou Yang , Martinez Leonardo , Kong Wen , Ding Xiaoyan , Peng Hong , Zhu Tao , Zhu Limei , Lu Wei
Published: April 2020

Background

Discordance between the QuantiFERON-TB Gold In-tube (QFT) and tuberculin skin test (TST) is not well understood. We aimed to identify the factors that determine discordance between the TST and QFT when compared to either TST+QFT+ or TST-QFT- results in a medium tuberculosis (TB) burden setting.

Methods

We conducted a population-based study in Eastern China and administered TSTs and QFTs to participants. We calculated kappa values while constructing multivariable logistic regression models to evaluate predictors of test discordance. We analyzed the predictive value of discordant and concordant test results for progression to TB over 6 years of follow-up.

Results

Overall, 5405 participants were enrolled; 2043 (37.8%) and 1104 (20.4%) were TST and QFT positive, respectively. There was fair agreement between the TST and the QFT (kappa values between 0.30–0.39 at different TST cutoffs). Agreement was lower among participants vaccinated with Bacillus Calmette-Guerin (BCG; κ, 0.17 versus 0.47 in nonvaccinated participants). TST+QFT- results were associated with decreasing age, smoking, undiagnosed diabetes, and BCG vaccination (adjusted odds ratio, 1.45; 95% confidence interval [CI], 1.11–1.90). TST-QFT+ results were associated with increasing age, male sex, smoking, and diagnosed diabetes. Compared to participants with TST-QFT- results, QFT+ and TST+QFT+ participants were 6.3 (95% CI, 1.9–20.4) and 7.5 (95%CI, 2.3–25.1) times more likely to progress to TB, respectively.

Conclusions

In this population-based study of over 5000 participants from a medium TB burden region, the test agreement between QFT and TST was fair overall and we found multiple novel predictors of discordant QFT/TST results. QFT provides a substantial improvement to the TST among these populations and was multi-fold better at predicting progression to TB.
Are current accounts driven by cost competitiveness or asset prices? A synthetic model and an empirical test
Authors: Guschanski Alexander , Stockhammer Engelbert
Published: April 2020

While current account imbalances have widened in recent decades, their causes are still debated. Trade-centred approaches highlight the role of cost competitiveness, in particular unit labour costs, and aggregate demand. In contrast, finance-centred approaches focus on gross financial flows, driven by expectations and the return on assets, that impact demand and the exchange rate. This article, first, builds a simple model of the current account that provides a synthesis between the two approaches. Unit labour costs impact the current account via the real exchange rate and income distribution, while financial inflows drive up asset prices, which leads to nominal appreciation and an increase in domestic demand. Second, we estimate a reduced form of this model for 28 OECD countries from 1972 to 2014, controlling for both trade- and finance-centred channels and a wide range of control variables. Our results indicate that finance-centred channels, via equity and residential property prices, drove current account divergence in the OECD, while unit labour costs were less important. They suggest that the effects of gross financial flows deserve more attention in theoretical and empirical models of the current account.
Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans
Authors: Wang Rui , He Hong , Liao Cong , Hu Hongtao , Hu Chun , Zhang Juan , Gao Ping , Wu Xiaoyan , Cheng Zhenshun , Liao Meiyan , Shui Hua
Published: April 2020

Background

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide.

Methods

We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans.

Results

Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead.

Conclusions

Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.
Are we curing one evil with another? A translational approach targeting the role of neoatherosclerosis in late stent failure
Authors: Lenz Tobias , Nicol Philipp , Castellanos Maria Isabel , Abdelgalil Ayat Aboutaleb Abdellah , Hoppmann Petra , Kempf Wolfgang , Koppara Tobias , Lahmann Anna Lena , Rüscher Alena , Kessler Horst , Joner Michael
Published: April 2020

Neoatherosclerosis is defined as foamy macrophage infiltration into the peri-strut or neointimal area after stent implantation, potentially leading to late stent failure through progressive atherosclerotic changes including calcification, fibroatheroma, thin-cap fibroatheroma, and rupture with stent thrombosis (ST) in advanced stages. Human autopsy as well as intravascular imaging studies have led to the understanding of neoatherosclerosis formation as a similar but significantly accelerated pathophysiology as compared to native atherosclerosis. This acceleration is mainly based on disrupted endothelial integrity with insufficient barrier function and augmented transmigration of lipids following vascular injury after coronary intervention and especially after implantation of drug-eluting stents. In this review, we summarize translational insights into disease pathophysiology and discuss therapeutic approaches to tackle this novel disease entity. We introduce a novel animal model of neoatherosclerosis alongside accompanying in vitro experiments, which show impaired endothelial integrity causing increased permeability for low-density lipoprotein cholesterol resulting in foam cell transformation of human monocytes. In addition, we discuss novel intravascular imaging surrogates to improve reliable diagnosis of early stage neoatherosclerosis. Finally, a therapeutic approach to prevent in-stent neoatherosclerosis with magnesium-based bioresorbable scaffolds and systemic statin treatment demonstrated the potential to improve arterial healing and re-endothelialization, leading to significantly mitigated neoatherosclerosis formation in an animal model of neoatherosclerosis.
Parental mortality following the loss of a child to a drug-related death
Authors: Christiansen Solveig Glestad , Reneflot Anne , Stene-Larsen Kim , Johan Hauge Lars
Published: April 2020

Background

The drug-related death of a child has been linked to higher prevalence of complicated grief and mental health problems than bereavement by other causes of death. Whether this leads to an increased risk of mortality following the loss has not yet been examined.

Methods

Employing register data covering the years 1986–2015 and encompassing the entire Norwegian population, parents with at least one child aged 15 or older were analyzed using Cox regression. Drug-death bereaved parents were compared with both non-bereaved parents and parents bereaved by other causes of death.

Results

Parents bereaved by a drug-related death generally had a higher natural cause mortality throughout the follow-up. Drug-death bereaved parents had a particularly high external cause mortality in the first 2 years subsequent to bereavement when compared with non-bereaved parents (mothers: hazard ratio 4.82, 95% CI = 3.11–7.47; fathers: hazard ratio 2.50, 95% CI = 1.57–3.97). There was also an elevated, but significantly lower mortality risk from external causes 2 to 10 years subsequent to bereavement. This indicates that the associations observed are not solely due to selection.

Conclusions

Parents bereaved by the drug-related death of a child had a higher mortality than both non-bereaved parents and parents bereaved by other causes of death. Drug-death bereaved parents had particularly high external cause mortality. Our results indicate that losing a child to a drug-related death is associated with adverse health outcomes and that these might be more severe than bereavement due to other causes of death.