bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes clinic reinvented: will technology change the future of diabetes care?
Authors: Al-Badri Marwa , Hamdy Osama
Published: March 2021

Diabetes is a chronic disease that affects nearly 463 million people globally and involves multiple co-morbid conditions that require effective treatment and continuous management. These include lifestyle and behavioral modifications, compliance to diabetes medications and close patient monitoring, all of which can be efficiently conducted via telehealth. Integrating digital technology of telehealth and mobile health into diabetes care may improve diabetes management and increase its efficiency. In this review, we examine recent advances in healthcare technology of diabetes. Moreover, we present an example of a comprehensive virtual diabetes clinic, the “Joslin HOME,” as an innovative digital ecosystem for future application in diabetes care. This model utilizes digital health technology and comprises frequent short visits with easy two-way scheduling, focused documentation and simple billing methods. In this new model, a multidisciplinary team is connected with their patients using telehealth and mobile health to overcome the barriers of distance and location. It may possibly extend quality diabetes care to remote, underserved or rural areas.
Super-refractory status epilepticus in a 29-year-old pregnant female
Authors: Carrasco Cinthya , Schwalk Audra , Hwang Byungkwan , Iwuji Kenneth , Islam Ebtesam
Published: March 2021

Super-refractory status epilepticus is a rare medical and neurological emergency due to the high mortality and morbidity associated with this condition. Furthermore, there is very little data regarding its incidence, etiology, and management in the pregnant population with super-refractory status epilepticus. The treatment of super-refractory status epilepticus during pregnancy is specifically a major challenge as there are limited available therapeutic options due to the well-established teratogenicity of most antiepileptic drugs and the unknown safety profile of some of the anesthetics commonly used for seizure control. We report a case of successfully treated super-refractory status epilepticus in a 29-year-old, 26 weeks pregnant female who after an emergent delivery and prolonged exposure to multiple antiepileptic drugs recovered full neurological function.
Detecting Streptococcus suis by nanopore sequencing in endophthalmitis: A case report
Authors: Wang Yi-Yan , Huang Qiong , Cheng Yang
Published: March 2021

Endophthalmitis is a rare and infectious disease caused by Streptococcus suis (S suis). Traditionally, S suis is detected by the pathogenic microorganism culture method, which has low positivity and high false negativity. Nanopore sequencing (NS), which is a third-generation sequencing technology, has several advantages over the traditional method; in particular, it is cost and time effective and has a high throughput. In this report, a case of infectious endophthalmitis caused by trauma is examined. The NS results suggest that the pathogen in question is a mixed infection caused by S suis and Clostridium perfringens. This case report provides evidence of the fact that NS can quickly identify pathogens, which is of great significance for clinical diagnosis and treatment.
Improving Questionnaires for Medical Surveillance of Hazardous Drug Exposure: Results of a Pilot Study
Authors: Mitchell Peter , McGovern Patricia Marie , Kirkhorn Steven
Published: March 2021

Background:

Numerous drugs pose harm to healthcare workers. Medical surveillance (MS) questionnaires often do not capture desired information. Social cognitive theory, plain language, and quality improvement were explored to design an MS questionnaire. The goal of this study was to pilot test an MS questionnaire assessing employees’ hazardous drug (HD) exposures consistent with a 2016 public standard addressing safe handling of HDs in health care.

Methods:

A cross-sectional study design was used to conduct qualitative analysis of questionnaire data collected from a convenience sample of three to five employees from each of the four departments at elevated risk of HD exposures in a large tertiary healthcare organization. Key research questions addressed employees’ understanding of questionnaire items and interview completion rates.

Findings:

Fourteen employees (oncology nurses, pharmacy technicians, housekeepers, and laundry workers) participated. None had participated in the organization’s prior hazardous drug medical surveillance (HDMS) activities. For the surveillance process, employees preferred in-person interviews to emailed questionnaires. Challenges for questionnaire comprehension related to employees’ basic skills of literacy and numeracy.

Conclusion/Application to Practice:

Strategies for ensuring employee comprehension of health and safety communications are critical. Questionnaires should be written in plain language employees can understand the first time it is read.
Association of COVID-19 Pandemic and Rate of Cognitive Decline in Patients with Dementia and Mild Cognitive Impairment: A Cross-sectional Study
Authors: Ismail Ismail Ibrahim , Kamel Walaa A. , Al-Hashel Jasem Y.
Published: March 2021

Introduction: Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, patients with dementia, were specifically vulnerable to the negative impact of the outbreak. Objective: To examine the association between lockdown amid COVID-19 pandemic and the rate of cognitive decline among patients with dementia and mild cognitive impairment (MCI). Methods: We conducted a cross-sectional observational study on patients with dementia and MCI who attended the outpatient clinic at Ibn Sina Hospital, the main tertiary neurology center in Kuwait, during the month of September 2020. The rate of cognitive decline, estimated by MMSE scores, was compared between the period prior to, and during lockdown. Results: We evaluated 36 consecutive patients with cognitive impairment (23 females [63.9%], mean age 71 ± 10.8 years, mean disease duration 34.6 ± 29 months). Eleven patients (30.6%) progressed to a more severe stage during the study period; 1 MCI (2.8%) converted to mild dementia, 6 (16.6%) mild to moderate, and 4 (11.1%) moderate to severe dementia. Monthly decline of MMSE scores before lockdown was 0.2 ± 0.1 points, while it was 0.53 ± 0.3 points during lockdown, which was statistically significant ( p = .001). The most affected cognitive domain was the memory with a mean decline of 1.5 ± 0.8 points. Conclusions: This study provides “real-world” data suggesting rapid cognitive decline in patients with dementia during the lockdown period. Healthcare systems should pay more attention to this vulnerable group, to help them maintain their mental, physical and social well-being during this crisis.
Factors Influencing Loss to Follow-up among Human Immunodeficiency Virus Exposed Infants in the Early Infant Diagnosis Program in Phalombe, Malawi
Authors: Nkhonjera Joe , Suwedi-Kapesa Leticia C. , Kumwenda Benjamin , Nyondo-Mipando Alinane Linda
Published: March 2021

The efforts to prevent mother to child transmission of HIV in Malawi are impeded by the loss to follow-up of HIV-exposed infants (HEI) in care. Early infant diagnosis (EID) of HEI and linkage to care reduces morbidity and mortality. There has been limited attention to infants who are lost to follow up despite their mothers being compliant to the PMTCT program. This study explored factors that influence loss-to-follow up among HEI in the EID program whose mothers were retained in care for up to 24 months in Phalombe district, Malawi. We conducted a descriptive phenomenological qualitative study from May 2017 to July 2018. We purposively conducted 18 in-depth interviews among HIV positive mothers whose HEI were enrolled in the follow-up program and 7 key informant interviews among healthcare workers (HCW). All interviews were digitally recorded, transcribed, and translated verbatim. Data were analyzed manually using a thematic step-by-step approach. Results showed that retention in care is facilitated by aspirations to have a healthy infant and linkage to a nearer facility to a mother’s place of residency. The barriers to retention were non-disclosure of HIV status, inadequate resources, and support, suboptimal guidelines for, a lack of privacy, and unsynchronized hospital visits between a mother and her baby. The study has shown that successful implementation of EID services requires concerted efforts from various contextualized stakeholders whilst focusing on family-centered care. To maximize retention in EID and innovative ways of reaching mothers and babies through flexible guidelines are urgently needed.
Impact of Structured and Scheduled Family Meetings on Satisfaction in Patients Admitted to Hospitalist Service
Authors: Gambhir Harvir Singh , Goodrick Samantha , Dhamoon Amit , Kaul Viren
Published: March 2021

Effective communication is key to patient satisfaction. Family meetings been shown to be effective in other settings such as critical care and palliative medicine. We evaluated the impact of scheduled and structured family meetings on patients admitted to the hospitalist service in terms of satisfaction with care delivery. More patients in the intervention group reported better understanding of their diagnosis, treatment plan, medications, and discharge plan. Based on these results, we advocate for structured and scheduled family meetings to be implemented as a communication tool for selected patients on the hospital medicine service to improve patient experience and satisfaction.
Comportment Management in the Hospital: Where Is Patient’s Health Care Station?
Authors: de Nichilo Stefano
Published: March 2021

This article analyzes the factors that explain the increased use of special reports by hospital facility auditors, such as the structured interview, wondering if they look like evaluation studies. It examines their training, impact, and the institutional use implicit in the performance audit. From an anthropological perspective, the audit could traditionally be considered as “Rituals of Verification,” recognizing the procedure and the evaluation of social effects, in public management. Therefore, sampling represents an effective and efficient tool for carrying out the statutory audit activity in the health care facilities where the coronavirus disease (COVID-19) virus is treated. However, the performance established a regulatory dimension compared to the concept of verification. In addition, auditing practices may often seem “trivial, inevitable part of a bureaucratic process,” but taken together and over time, they are probably part of a distinct cultural artifact. As we have seen, the reasons that justify the activation of a clinical audit can be numerous: patient complaints, occurrence of adverse events such as the case of COVID-19, performance with inadequate results, publication of new guidelines; however, the “bet” is that in the future the awareness that auditing is an irreplaceable part of professional practice will mature among professionals.
Effectiveness of Health Guidance Simulation in Community Settings for Public Health Nursing Students: A Preliminary Study
Authors: Yoshioka-Maeda Kyoko , Naruse Kazuko
Published: March 2021

Introduction

Simulation-based learning is a relatively new concept in public health nursing education, and little is known about the efficacy of this approach for teaching of health guidance.

Objective

The aim of this study was to evaluate the effectiveness of health guidance simulation in community settings for public health nursing students.

Methods

Using a pre/post-test design, 29 public health nursing students in their third year participated in a high-fidelity simulation program with standardized patients. We developed six scenarios on health guidance for three themes (mother and child, tuberculosis, and adult occupational health) and practice guidelines for the standardized patients to act and assist in understanding of the purpose of the course. Data were collected at baseline and after the simulation sessions through evaluation sheets that the students placed in a designated box on campus. Changes in the level of self-confidence of the students were evaluated based on the “practical skills required for public health nurses and achievement level at graduation” of the Ministry of Health, Labor and Welfare, and the skills in the minimum requirements for public health nurse education defined by the Japan Association of Public Health Nurse Educational Institutions.

Results

The total score for self-confidence and the mean self-confidence scores for health guidance skills for mother and child, tuberculosis, and adult occupational health nursing were significantly higher post-test compared to pre-test ( p < 0.001).

Conclusion

These results indicate that high-fidelity simulation focused on health guidance in community settings can bridge the gap between theoretical knowledge and practice of students.
Inclusive Business for Smallholders’ Household Food and Nutrition Security: Disconcerting Results from an Analysis of a French Bean Agri-investment in Kenya
Authors: Wangu James , Mangnus Ellen , van Westen A. C. M. (Guus) , Vocht Alphons de
Published: March 2021

Inclusive business is regarded as having the potential to improve food security status in the Global South. Despite increased popularity among governments, donors and other development stakeholders, little is known about the approach’s impact on smallholder farmer communities. As such, the above-mentioned inclusive business promise on food security status largely rests on assumptions. This article scrutinises a case of smallholders’ French bean production for export market in Tharaka Nithi County, Kenya. The business model adopted in the initiative is termed inclusive and is intended to enhance food and nutrition security in the community. The empirical findings show that several contextual factors—in particular, access to land and water resources—limit the participation of the majority of farmers in the community. This leads to a notable level of exclusion. Moreover, the company risks negatively influencing local food security when food crops are substituted for an export crop that is not consumed locally. Results of this article demonstrate that while private sector-led development might contribute to higher economic productivity and access to food of better quality, it rarely changes the structural causes of food and nutrition insecurity, which are oftentimes related to access to production resources. We plead for increased scrutiny of the contextual factors when designing and implementing inclusive business models.
High-Pressure Injection Injuries to the Foot: A Case Report of 2 Patients
Authors: Gerzina Christopher , Suryavanshi Joash , Grimes Jerry
Published: March 2021

Background:

High-pressure injections injuries to the extremities can result in significant disability, including amputation of the affected limb. Proprietary mixtures associated with drill mud and hydraulic fracking leads to frequent encounters with varied materials. The physician needs to be aware of the effect of these materials when inadvertent exposure occurs. Injected toxic materials cause extensive soft tissue inflammation and destruction. This puts the foot at risk not only to the cleaning fluid used, generally water, but any contaminant on the boot at the time of injury. This case report is the first known case report involving injection with drill mud contaminant and describes 2 oil field injuries resulting in the gross deep contamination of the foot from a high-pressure washer injury.

Case Report:

Two patients, a 46-year-old man (patient 1) and a 29-year-old man (patient 2) sustained high-pressure injection injuries to the foot. These patients underwent treatment with immediate broad-spectrum antibiotics and emergent irrigation and debridement on arrival to the treating facility. Neither patient underwent amputation of the affected extremity as a result of their injuries and achieved a full recovery and return to work.

Conclusion:

High-pressure injection injuries are operative emergencies. Treatment should include tetanus prophylaxis, neurovascular monitoring, broad-spectrum antibiotic coverage, emergent operative debridement for toxic materials. Despite the toxic nature of the injection injuries, aggressive treatment can improve the chance of salvage in these industrial injuries.
The Percentile Bootstrap: A Primer With Step-by-Step Instructions in R
Authors: Rousselet Guillaume A. , Pernet Cyril R. , Wilcox Rand R.
Published: March 2021

The percentile bootstrap is the Swiss Army knife of statistics: It is a nonparametric method based on data-driven simulations. It can be applied to many statistical problems, as a substitute to standard parametric approaches, or in situations for which parametric methods do not exist. In this Tutorial, we cover R code to implement the percentile bootstrap to make inferences about central tendency (e.g., means and trimmed means) and spread in a one-sample example and in an example comparing two independent groups. For each example, we explain how to derive a bootstrap distribution and how to get a confidence interval and a p value from that distribution. We also demonstrate how to run a simulation to assess the behavior of the bootstrap. For some purposes, such as making inferences about the mean, the bootstrap performs poorly. But for other purposes, it is the only known method that works well over a broad range of situations. More broadly, combining the percentile bootstrap with robust estimators (i.e., estimators that are not overly sensitive to outliers) can help users gain a deeper understanding of their data than they would using conventional methods.
Power Analysis for Parameter Estimation in Structural Equation Modeling: A Discussion and Tutorial
Authors: Wang Y. Andre , Rhemtulla Mijke
Published: March 2021

Despite the widespread and rising popularity of structural equation modeling (SEM) in psychology, there is still much confusion surrounding how to choose an appropriate sample size for SEM. Currently available guidance primarily consists of sample-size rules of thumb that are not backed up by research and power analyses for detecting model misspecification. Missing from most current practices is power analysis for detecting a target effect (e.g., a regression coefficient between latent variables). In this article, we (a) distinguish power to detect model misspecification from power to detect a target effect, (b) report the results of a simulation study on power to detect a target regression coefficient in a three-predictor latent regression model, and (c) introduce a user-friendly Shiny app, pwrSEM, for conducting power analysis for detecting target effects in structural equation models.
Simulation-Based Power Analysis for Factorial Analysis of Variance Designs
Authors: Lakens Daniël , Caldwell Aaron R.
Published: March 2021

Researchers often rely on analysis of variance (ANOVA) when they report results of experiments. To ensure that a study is adequately powered to yield informative results with an ANOVA, researchers can perform an a priori power analysis. However, power analysis for factorial ANOVA designs is often a challenge. Current software solutions do not allow power analyses for complex designs with several within-participants factors. Moreover, power analyses often need [Formula: see text] or Cohen’s f as input, but these effect sizes are not intuitive and do not generalize to different experimental designs. We have created the R package Superpower and online Shiny apps to enable researchers without extensive programming experience to perform simulation-based power analysis for ANOVA designs of up to three within- or between-participants factors. Predicted effects are entered by specifying means, standard deviations, and, for within-participants factors, the correlations. The simulation provides the statistical power for all ANOVA main effects, interactions, and individual comparisons. The software can plot power across a range of sample sizes, can control for multiple comparisons, and can compute power when the homogeneity or sphericity assumption is violated. This Tutorial demonstrates how to perform a priori power analysis to design informative studies for main effects, interactions, and individual comparisons and highlights important factors that determine the statistical power for factorial ANOVA designs.
The use of note-taking during forensic interviews: Perceptions and practical recommendations for interviewers
Authors: Baker Matthew , Fessinger Melanie , McWilliams Kelly , Williams Shanna
Published: March 2021

The disclosure process for children who have experienced maltreatment is often difficult. In an effort to support children in their disclosures, interviewers have increasingly turned to empirically-based interview protocols (i.e., questioning strategies) that both decrease the suggestibility of questions while also increasing the productivity of children’s statements. Despite efforts to improve the structure of forensic interviews, interviewing support tools, such as note-taking, have received less empirical attention. To date, research examining interviewers’ notes has primarily focused on the accuracy of such records for evidentiary reasons. Yet, note-taking may serve other purposes; for instance, the process of note-taking may increase the accuracy of interviewers’ questions (i.e., use of child’s words) and memory (i.e., follow-up questions and themes) throughout the interview. In the current review, we describe the limited forensic note-taking literature, as well as the potential strengths and weaknesses of note-taking during forensic interviews with children. We end by suggesting potential avenues of research to assist with the creation of practical guidelines for the use of notes during forensic interviews.
Stroke Care During the COVID-19 Pandemic: Asian Stroke Advisory Panel Consensus Statement
Authors: Pandian Jeyaraj D. , Kusuma Yohanna , Kiemas Lyna Soertidewi , Lee Tsong-Hai , Navarro Jose C. , Nilanont Yongchai , Suwanwela Nijasri C. , Chiu Hou-Chang , Kwon Sun-Uck , Tan Kay Sin , Thang Nguyen Huy , Yoon Byung-Woo , Tan Ju Lie , Venketasubramanian Narayanaswamy
Published: March 2021

The COVID-19 pandemic has impacted the health system worldwide. Stroke is one of the leading causes of death and disability in the world. Asia has a diverse health system and more than two-thirds of strokes occur in this region. The Asian Stroke Advisory Panel (ASAP) conducted a survey among the member countries to explore the impact of COVID-19 on stroke care. The stroke admission numbers have fallen, as have the number of patients who received thrombolysis and mechanical thrombectomy. The stroke unit and rehabilitation beds have been reallocated for COVID-19 care. ASAP recommends emergency department screening of stroke patients for COVID-19 and protected stroke code to be activated for COVID-19 suspect stroke patients. Noncontrast computed tomography (CT), CT angiography, and CT chest are the imaging modalities of choice. All health care professionals involved in triaging, imaging, and stroke care should wear appropriate personal protective equipment. All eligible stroke patients (COVID suspect/positive/non-COVID) should receive intravenous thrombolysis/mechanical thrombectomy. Mobile stroke units and robots can be used wherever available for evaluation and triaging. All stroke patients should receive standard stroke unit care. Limited rehabilitation should be offered to patients and training of caregivers if needed. Telemedicine/telestroke should be used for rehabilitation and follow-up. The ASAP consensus statement can be adapted to suit local and national health care systems.
How should we do colon capsule endoscopy reading: a practical guide
Authors: Koulaouzidis Anastasios , Dabos Konstantinos , Philipper Michael , Toth Ervin , Keuchel Martin
Published: March 2021

In this article, we aim to provide general principles as well as personal views for colonic capsule endoscopy. To allow an in-depth understanding of the recommendations, we also present basic technological characteristics and specifications, with emphasis on the current as well as the previous version of colonic capsule endoscopy and relevant software. To date, there is no scientific proof to support the optimal way of reading a colonic capsule endoscopy video, or any standards or guidelines exist. Hence, any advice is a mixture of recommendations by the capsule manufacturer and experts’ opinion. Furthermore, there is a paucity of data regarding the use of term(s) (pre-reader/reader-validator) in colonic capsule endoscopy. We also include a couple of handy tables in order to get info at a glance.
Phase 2 study of ibrutinib in classic and variant hairy cell leukemia
Authors: Rogers Kerry A. , Andritsos Leslie A. , Wei Lai , McLaughlin Eric M. , Ruppert Amy S. , Anghelina Mirela , Blachly James S. , Call Timothy , Chihara Dai , Dauki Anees , Guo Ling , Ivy S. Percy , James Lacey R. , Jones Daniel , Kreitman Robert J. , Lozanski Gerard , Lucas David M. , Ngankeu Apollinaire , Phelps Mitch , Ravandi Farhad , Schiffer Charles A. , Carson William E. , Jones Jeffrey A. , Grever Michael R.
Published: March 2021

Hairy cell leukemia (HCL) is a rare B-cell malignancy, and there is a need for novel treatments for patients who do not benefit from purine analogs. Ibrutinib, an oral agent targeting Bruton tyrosine kinase in the B-cell receptor signaling pathway, is highly effective in several malignancies. Its activity in HCL was unknown, so we conducted a multisite phase 2 study of oral ibrutinib in patients with either relapsed classic or variant hairy cell leukemia. The primary outcome measure was the overall response rate (ORR) at 32 weeks, and we also assessed response at 48 weeks and best response during treatment. Key secondary objectives were characterization of toxicity and determination of progression-free survival (PFS) and overall survival (OS). Thirty-seven patients were enrolled at 2 different doses (24 at 420 mg, 13 at 840 mg). The median duration of follow-up was 3.5 years (range, 0-5.9 years). The ORR at 32 weeks was 24%, which increased to 36% at 48 weeks. The best ORR was 54%. The estimated 36-month PFS was 73% and OS was 85%. The most frequent adverse events were diarrhea (59%), fatigue (54%), myalgia (54%), and nausea (51%). Hematologic adverse events were common: anemia (43%), thrombocytopenia (41%), and neutropenia (35%). Ibrutinib can be safely administered to patients with HCL with objective responses and results in prolonged disease control. Although the initial primary outcome objective of the study was not met, the observation of objective responses in heavily pretreated patients coupled with a favorable PFS suggests that ibrutinib may be beneficial in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01841723.
Validation of the Arabic linguistic version of the International Consultation on Incontinence Questionnaire-overactive bladder (ICIQ-OAB)
Authors: Taha Diaa-Eldin , Elbaset M. A. , Hashem Abdelwahab , Nabeeh Hossam , Ibrahim Ali , Pardoe Megan N. , Elhefnawy Ahmed S.
Published: March 2021

Background

Overactive bladder (OAB) is a health burden that needs an Arabic assessment tool. The idea is to validate the Arabic version of the International Consultation on Incontinence Questionnaire-overactive bladder (ICIQ-OAB).

Methods

A multicenter cross-sectional study carried out between March 2019 and February 2020. The translated ICIQ-OAB was used to assess the 227 patients. The enrolled patients were 112 complaining of symptoms suggestive of OAB, 115 healthy without LUTS symptoms. Additionally, patients with and without BOO symptoms were included. The reliability assessment of the internal consistency was done using Cronbach’s α test. With the aid of Spearman’s correlation coefficient (r), the interdomain associations were assessed. The Mann–Whitney test was used to assess the discrimination validity.

Results

A high internal consistency between the mean scores of women with and those without OAB as well as BOO groups, Cronbach’s alpha value was 0.82. A strong correlation obviates among whole ICIQ domains in OAB set (P ≤ 0.001). Equally, a high correlation exists among each domain in the BOO group, and Cronbach’s alpha value was 0.82. In comparison with control, highly significant scores exist for all ICIQ-OAB domains and entire points in the BOO as well as OAB sets (P < 0.001). The ICIQ-OAB was found to have good discriminant validity.

Conclusion

A formulated and approved ICIQ-OAB -Arabic release is a value tool for addressing OAB symptom complex. The easy questionnaire will be a useful tool in grading the bother symptoms in Arabic speaking inhabitant.
SAveRUNNER: an R-based tool for drug repurposing
Authors: Fiscon Giulia , Paci Paola
Published: March 2021

Background

Currently, no proven effective drugs for the novel coronavirus disease COVID-19 exist and despite widespread vaccination campaigns, we are far short from herd immunity. The number of people who are still vulnerable to the virus is too high to hamper new outbreaks, leading a compelling need to find new therapeutic options devoted to combat SARS-CoV-2 infection. Drug repurposing represents an effective drug discovery strategy from existing drugs that could shorten the time and reduce the cost compared to de novo drug discovery.

Results

We developed a network-based tool for drug repurposing provided as a freely available R-code, called SAveRUNNER (Searching off-lAbel dRUg aNd NEtwoRk), with the aim to offer a promising framework to efficiently detect putative novel indications for currently marketed drugs against diseases of interest. SAveRUNNER predicts drug–disease associations by quantifying the interplay between the drug targets and the disease-associated proteins in the human interactome through the computation of a novel network-based similarity measure, which prioritizes associations between drugs and diseases located in the same network neighborhoods.

Conclusions

The algorithm was successfully applied to predict off-label drugs to be repositioned against the new human coronavirus (2019-nCoV/SARS-CoV-2), and it achieved a high accuracy in the identification of well-known drug indications, thus revealing itself as a powerful tool to rapidly detect potential novel medical indications for various drugs that are worth of further investigation. SAveRUNNER source code is freely available at https://github.com/giuliafiscon/SAveRUNNER.git, along with a comprehensive user guide.
Co-expression of double-stranded RNA and viral capsid protein in the novel engineered Escherichia coli DualX-B15(DE3) strain
Authors: Wuthisathid Kitti , Chaijarasphong Thawatchai , Chotwiwatthanakun Charoonroj , Somrit Monsicha , Sritunyalucksana Kallaya , Itsathitphaisarn Ornchuma
Published: March 2021

Background

Viruses cause significant economic losses to shrimp aquaculture worldwide. In severe cases, they can lead to 100% mortality within a matter of days, hence the aquaculture industry requires antiviral strategies to minimize economic impacts. Currently, a double-stranded RNA (dsRNA)-based platform has been proven effective at a laboratory scale. The bottleneck for its industrialization is the lack of low-cost, efficient and practical delivery approaches. In an effort to bridge the gap between laboratory and farm applications, virus-like particles (VLP) have been used as nanocarriers of dsRNA. However, the implementation of this approach still suffers from high costs and a lengthy procedure, co-expression of subunits of VLP or capsid proteins (CPs) and dsRNA can be the solution for the problem. CP and dsRNA are traditionally expressed in two different E. coli hosts: protease-deficient and RNase III-deficient strains. To condense the manufacturing of dsRNA-containing VLP, this study constructed a novel E. coli strain that is able to co-express viral capsid proteins and dsRNA in the same E. coli cell.

Results

A novel bacterial strain DualX-B15(DE3) was engineered to be both protease- and RNase III-deficiency via P1 phage transduction. The results revealed that it could simultaneously express recombinant proteins and dsRNA.

Conclusion

Co-expression of viral capsid proteins and dsRNA in the same cell has been shown to be feasible. Not only could this platform serve as a basis for future cost-effective and streamlined production of shrimp antiviral therapeutics, it may be applicable for other applications that requires co-expression of recombinant proteins and dsRNA.
In-laboratory breast specimen radiography reduces tissue block utilization and improves turnaround time of pathologic examination
Authors: Arudra Sri Krishna Chaitanya , Garvey Laura C. , Hagemann Ian S.
Published: March 2021

Background

This study was performed to determine whether in-laboratory specimen radiography reduces turnaround time or block utilization in surgical pathology.

Methods

Specimens processed during a 48-day trial of an in-lab cabinet radiography device (Faxitron) were compared to a control group of specimens imaged in the mammography suite during a prior 1-year period, and to a second group of specimens not undergoing imaging of any type.

Results

Cases imaged in the mammography suite had longer turnaround time than cases not requiring imaging (by 1.15 days for core biopsies, and 1.73 days for mastectomies; p < 0.0001). In contrast, cases imaged in-lab had turnaround time that was no longer than unimaged cases (p > 0.05 for core biopsies, lumpectomies and mastectomies). Mastectomies imaged in-lab required submission of fewer blocks than controls not undergoing any imaging (mean reduction of 10.6 blocks).

Conclusions

Availability of in-lab radiography resulted in clinically meaningful improvements in turnaround time and economically meaningful reductions in block utilization.
PRIME-HCC: phase Ib study of neoadjuvant ipilimumab and nivolumab prior to liver resection for hepatocellular carcinoma
Authors: Pinato David J. , Cortellini Alessio , Sukumaran Ajithkumar , Cole Tom , Pai Madhava , Habib Nagy , Spalding Duncan , Sodergren Mikael H. , Martinez Maria , Dhillon Tony , Tait Paul , Thomas Robert , Ward Caroline , Kocher Hemant , Yip Vincent , Slater Sarah , Sharma Rohini
Published: March 2021

Background

After liver resection (LR), patients with hepatocellular cancer (HCC) are at high risk of recurrence. There are no approved anti-cancer therapies known to affect such risk, highlighting the acute need for novel systemic therapies to control the probability of disease relapse. Immunotherapy is expanding as a novel treatment option for HCC. Emerging data from cohort 4 of the CA209–040 study, which investigated the safety and preliminary efficacy of nivolumab/ipilimumab co-administration in advanced HCC, suggest that the combination can be delivered safely with an acceptable proportion of reversible grade 3–4 toxicities (27.1%) and a low discontinuation rate (2%) in patients with HCC. Here, we describe the design and rationale of PRIME-HCC, a two-part, multi-centre, phase Ib study to assess safety and bioactivity of the nivolumab/ipilimumab combination prior to LR in early-stage HCC.

Methods

The study involves an initial safety run-in phase (Part 1) to allow for preliminary safety characterisation within the first 6 patients enrolled and a subsequent expansion (Part 2). Ipilimumab will be administered once only on Day 1. Nivolumab will be administered on Day 1 and Day 22 (± 3 days) for a total of two 21-day cycles (i.e. 6 weeks of treatment). The primary objective of the study is to determine the safety and tolerability of the nivolumab/ipilimumab combination prior to LR. The secondary objective is to preliminarily characterize the efficacy of the combination prior to LR, including objective response rate (ORR) and pathologic response rates. Additional exploratory objectives include preliminary evidence of long-term disease control and to identify predictive correlates of response to the nivolumab/ipilimumab combination in HCC.

Discussion

The results of this study will help define the positioning of neoadjuvant nivolumab/ipilimumab combination in the perioperative management of HCC, with potential to improve survival outcomes in this patient population.

Trial registration

EudraCT Number: 2018–000987-27 Clinical trial registry & ID: ClinicalTrials.gov: NCT03682276.
Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration
Authors: Forshaw Thomas Richard Johansen , Parpounas Alexandra Kalia , Sørensen Torben Lykke
Published: March 2021

Background

Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant.

Methods

Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.

Results

There was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458;p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446;p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542;p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469;p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652;p < 0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r = 0.469;p = 0.012).

Conclusions

Macular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD.

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Prevalence of dry eye syndrome in association with the use of contact lenses in Saudi Arabia
Authors: Almutairi Abeer Habeeb , Alalawi Bayan Sulaiman , Badr Ghadir Hamzah , Alawaz Razan Ahmed , Albarry Maan , Elbadawy Hossein M.
Published: March 2021

Background

Dry eye disease is a tear film disorder which can cause discomfort to patients and negatively affect vision acuity. A number of risk factors has been reported to affect the incidence and severity of dry eye syndrome (DES). The aim is to study the prevalence of DES in Saudi Arabia and the factors affecting the severity of DES in relation to the use of contact lenses.

Methods

A cross-sectional questionnaire-based study was conducted on 310 participants using the ocular surface disease index (OSDI) questionnaire and the eye dryness part from contact lens questionnaire-8 (CLDEQ-8). Dry eye OSDI scores were compared across different epidemiological and risk factors with focus on the use of contact lenses. Pearson and Spearman’s correlation coefficients were used to analyze the frequency of contact lenses usage in relation to OSDI scores. Student’s t-test and one-way analysis of variance (ANOVA) tests were used to compare means of two or more than two groups, respectively.

Results

Forty eight (15.5%) of participants did not have any degree of DES, achieving an OSDI score between 0 and 12. Forty participants (12.9%) scored from 13 to 22, (mild DES), 44 (14.2%) were moderate, scoring 23–32 on the OSDI, while those who scored above 33 were 178 (57.4%) had severe DES. The mean score for all participants was 37.8. A high percentage of participants (84.5%) had some degree of DES. There was a strong positive correlation between OSDI score and the frequency of the feeling of dry eye and a moderate positive correlation between OSDI score and the intensity of dryness feeling. Out of 310 participants, 136 (43.9%) indicated using contact lenses. There was no significant association between the use of contact lenses per se and DES, however, those who used contact lenses more frequently had significantly higher OSDI scores.

Conclusions

Dry eye syndrome is a widespread, underdiagnosed condition in Saudi Arabia. The frequency of contact lenses use may contribute to the incidence of DES.
Occupancy modeling and resampling overcomes low test sensitivity to produce accurate SARS-CoV-2 prevalence estimates
Authors: Sanderlin Jamie S. , Golding Jessie D. , Wilcox Taylor , Mason Daniel H. , McKelvey Kevin S. , Pearson Dean E. , Schwartz Michael K.
Published: March 2021

Background

We evaluated whether occupancy modeling, an approach developed for detecting rare wildlife species, could overcome inherent accuracy limitations associated with rapid disease tests to generate fast, accurate, and affordable SARS-CoV-2 prevalence estimates. Occupancy modeling uses repeated sampling to estimate probability of false negative results, like those linked to rapid tests, for generating unbiased prevalence estimates.

Methods

We developed a simulation study to estimate SARS-CoV-2 prevalence using rapid, low-sensitivity, low-cost tests and slower, high-sensitivity, higher cost tests across a range of disease prevalence and sampling strategies.

Results

Occupancy modeling overcame the low sensitivity of rapid tests to generate prevalence estimates comparable to more accurate, slower tests. Moreover, minimal repeated sampling was required to offset low test sensitivity at low disease prevalence (0.1%), when rapid testing is most critical for informing disease management.

Conclusions

Occupancy modeling enables the use of rapid tests to provide accurate, affordable, real-time estimates of the prevalence of emerging infectious diseases like SARS-CoV-2.
Changes in prevalence, and factors associated with tobacco use among Bangladeshi school students: evidence from two nationally representative surveys
Authors: Ahammed Tanvir , Ahmed Nasar U. , Uddin Md Jamal
Published: March 2021

Background

Globally, tobacco kills more than nine million people per year. Annually in Bangladesh, smoking accounts for 1.2 million illnesses and over one hundred fifty thousand deaths. Worldwide, about one out of five school students smoke tobacco, and this problem is also growing significantly in Bangladesh. There is a need to address this problem. However, to the best of knowledge, no published study has been evaluated the changes in factors associated with tobacco use over time among Bangladeshi adolescent students using large, nationally representative comparable surveys. Our objective was to identify the factors associated with tobacco use among school going students, examine any changes in them over time, and explore policy options based on national surveys.

Methods

We analysed the data from the 2007 and the 2013 Global Youth Tobacco Survey (GYTS), a school-based survey targeting adolescents age 13–15 years (7th–9th grade), developed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). The samples were selected based on a two-stage cluster sample design. The data were collected in school classes using a self-administered anonymous survey. We applied chi-square tests and survey logistic regression models for analysing the data.

Results

Overall tobacco usage significantly declined from 8.4 to 6.9% over six years. The prevalence of tobacco use decreased among females (5.22 to 2.84%), those who received anti-tobacco messages (8.93 to 7.24%) and because of age restriction could not buy tobacco products (18.86 to 15.78%). Compared with the female, the odds of overall tobacco smoking among male students was 1.97 (CI: 0.99–3.92) in the year 2007 and it increased (OR = 3.07; CI: 1.56–6.04) in the year 2013. Moreover, the odds of smoking among those exposed to tobacco smoke had increased (OR = 3.26; CI: 1.46–7.29 vs 5.43; CI: 1.63–18.07) from 2007 to 2013.

Conclusion

There was a decline in tobacco use, especially among female students. Male students were higher tobacco user. It appeared anti-smoking campaign and age restriction policies were working.
Nuclear factor-kappaB regulates the transcription of NADPH oxidase 1 in human alveolar epithelial cells
Authors: Wu Weijing , Li Li , Su Xiaoshan , Zhu Zhixing , Lin Xiaoping , Zhang Jiamin , Zhuang Zesen , Cai Hongyi , Huang Wenjie
Published: March 2021

Objective

Acute lung injury (ALI) is characterized by inflammation and oxidative stress. Nuclear factor-kappaB (NF-κB) mediates the expression of various inflammation-related genes, including the NADPH oxidase family. This study aimed to identify the potential regulatory role of NF-κB on NADPH oxidases in tumor necrosis factor-α (TNF-α)-induced oxidative stress in human alveolar epithelial cells.

Methods

A549 cells were treated with TNF-α for 24 h to establish ALI cell models. RT-PCR, western blot, assessment of oxidative stress, Alibaba 2.1 online analysis, electrophoretic mobility shift assays and luciferase reporter analysis were employed to identify the potential regulatory role of NF-κB on NADPH oxidases in TNF-α-induced oxidative stress in human alveolar epithelial cells.

Results

The expression of NF-κB/p65 was notably upregulated in TNF-α-stimulated A549 cells. NF-κB knockdown by siRNA significantly inhibited the TNF-α-induced oxidative stress. Moreover, NF-κB/p65 siRNA could inhibit the activation of NOX1, NOX2 and NOX4 mRNA and protein expression in TNF-α-stimulated A549 cells. The next study demonstrated that NF-κB activated the transcription of NOX1 by binding to the -261 to -252 bp (NOX1/κB2, TAAAAATCCC) region of NOX1 promoter in TNF-α-stimulated A549 cells.

Conclusion

Our data demonstrated that NF-κB can aggravate TNF-α-induced ALI by regulating the oxidative stress response and the expression of NOX1, NOX2 and NOX4. Moreover, NF-κB could promote the NOX1 transcriptional activity via binding its promoter in TNF-α-stimulated A549 cells.