bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Thoracic Skeletal Muscle Area Is Not Associated With Negative Outcomes in Patients With COVID-19
Authors: Moctezuma-Velázquez Paulina , Miranda-Zazueta Godolfino , Ortiz-Brizuela Edgar , González-Lara María Fernanda , Tamez-Torres Karla Maria , Román-Montes Carla Marina , Díaz-Mejía Bruno Alejandro , Pérez-García Esteban , Villanueva-Reza Marco , Tovar-Méndez Víctor Hugo , Medrano-Borromeo Carla , Martínez-Valenzuela Alejandra , Jandete-Medina Míguel Ángel , Martínez-Guerra Bernardo Alonso , Uscanga-Domínguez Luis , Sifuentes-Osornio José , Ponce-de-León Alfredo , Olivas-Martinez Antonio , Moctezuma-Velázquez Carlos
Published: February 2021

Objective

Sarcopenia has been related to negative outcomes in different clinical scenarios from critical illness to chronic conditions. The aim of this study was to verify whether there was an association between low skeletal muscle index and in-hospital mortality, intensive care unit admission, and invasive mechanical ventilation need in hospitalized patients with COVID-19.

Design

This was a retrospective cohort study of a referral center for COVID-19. We included all consecutive patients admitted to the hospital between February 26 and May 15, 2020, with a confirmed diagnosis of COVID-19. Skeletal muscle index was assessed from a transverse computed tomography image at the level of twelfth thoracic vertebra with National Institutes of Health ImageJ software, and statistical analysis was performed to find an association between skeletal muscle index and in-hospital mortality, need of invasive mechanical ventilation, and intensive care unit admission.

Results

We included 519 patients, the median age was 51 (42–61) yrs, and 115 patients (22%) had low skeletal muscle index. On multivariable analysis, skeletal muscle index was not associated with mortality, intensive care unit admission, or invasive mechanical ventilation need nor in a subanalysis of patients 65 yrs or older.

Conclusions

Skeletal muscle index determined by computed tomography at the level of twelfth thoracic vertebra was not associated with negative outcomes in hospitalized patients with COVID-19.
The Impact of Demographics on Child and Parent Ratings of Satisfaction with Hospital Care
Authors: Waldron Mia K. , Wathen Kourtney , Houston Sasha , Coleman Lael , Mason Janice J. , Wang Yunfei , Hinds Pamela S.
Published: February 2021

Introduction:

Patient satisfaction ratings differ between minority and nonminority respondents in studies of hospitalized adults, but little is known about such differences in pediatrics. Our goal was to determine if patient satisfaction ratings completed by hospitalized children and their parents at the point of discharge differed by race/ethnicity, language, child gender, and age.

Methods:

We used a mixed-methods design. English and Spanish-speaking families from 5 inpatient units at 1 pediatric hospital completed ratings, face-to-face, before scheduled hospital discharge (T1), and again by telephone after discharge (T2). Participating children and their parents completed an 8-item satisfaction survey, and parents additionally completed 7 discharge readiness items.

Results:

The refusal rate was 10.7%, with 600 families enrolled; non-white families represented 66% of both study refusals and completions. The proportion of racial/ethnic groups in our study exceeded those in our standard survey sample. There were no significant differences in satisfaction ratings between non-white and white families or by child gender, age, or language.

Conclusions:

The lack of rating differences by demographic characteristics, the low refusal and attrition rates, and a more racially/ethnically representative sample of both child and parent perspectives indicate this approach to measuring satisfaction is acceptable and feasible to demographically diverse families.
Feasibility and Successful Enrollment in a Proof-of-Concept HIV Prevention Trial of VRC01, a Broadly Neutralizing HIV-1 Monoclonal Antibody
Authors: Edupuganti Srilatha , Mgodi Nyaradzo , Karuna Shelly T. , Andrew Philip , Rudnicki Erika , Kochar Nidhi , deCamp Allan , De La Grecca Robert , Anderson Maija , Karg Carissa , Tindale India , Greene Elizabeth , Broder Gail B. , Lucas Jonathan , Hural John , Gallardo-Cartagena Jorge A. , Gonzales Pedro , Frank Ian , Sobieszczyk Magdalena , Gomez Lorenzo Margarita M. , Burns David , Anderson Peter L. , Miner Maurine D. , Ledgerwood Julie , Mascola John R. , Gilbert Peter B. , Cohen Myron S. , Corey Lawrence ,   the HVTN 704/HPTN 085 study group
Published: February 2021

Background:

The Antibody-Mediated Prevention trials (HVTN 704/HPTN 085 and HVTN 703/HPTN 081) are the first efficacy trials to evaluate whether VRC01, a broadly neutralizing monoclonal antibody targeting the CD4-binding site of the HIV envelope protein, prevents sexual transmission of HIV-1. HVTN 704/HPTN 085 enrolled 2701 cisgender men and transgender (TG) individuals who have sex with men at 26 sites in Brazil, Peru, Switzerland, and the United States.

Methods:

Participants were recruited and retained through early, extensive community engagement. Eligible participants were randomized 1:1:1 to 10 mg/kg or 30 mg/kg of VRC01 or saline placebo. Visits occurred monthly, with intravenous (IV) infusions every 8 weeks over 2 years, for a total of 10 infusions. Participants were followed for 104 weeks after first infusion.

Results:

The median HVTN 704/HPTN 085 participant age was 28 years; 99% were assigned male sex; 90% identified as cisgender men, 5% as TG women and the remaining as other genders. Thirty-two percent were White, 15% Black, and 57% Hispanic/Latinx. Twenty-eight percent had a sexually transmitted infection at enrollment. More than 23,000 infusions were administered with no serious IV administration complications. Overall, retention and adherence to the study schedule exceeded 90%, and the dropout rate was below 10% annually (7.3 per 100 person-years) through week 80, the last visit for the primary end point.

Conclusions:

HVTN 704/HPTN 085 exceeded accrual and retention expectations. With exceptional safety of IV administration and operational feasibility, it paves the way for future large-scale monoclonal antibody trials for HIV prevention and/or treatment.
A Phase 2b Study to Evaluate the Safety and Efficacy of VRC01 Broadly Neutralizing Monoclonal Antibody in Reducing Acquisition of HIV-1 Infection in Women in Sub-Saharan Africa: Baseline Findings
Authors: Mgodi Nyaradzo M. , Takuva Simbarashe , Edupuganti Srilatha , Karuna Shelly , Andrew Philip , Lazarus Erica , Garnett Precious , Shava Emily , Mukwekwerere Pamela G. , Kochar Nidhi , Marshall Kyle , Rudnicki Erika , Juraska Michal , Anderson Maija , Karg Carissa , Tindale India , Greene Elizabeth , Luthuli Nandisile , Baepanye Kagisho , Hural John , Gomez Lorenzo Margarita M. , Burns David , Miner Maurine D. , Ledgerwood Julie , Mascola John R. , Donnell Deborah , Cohen Myron S. , Corey Lawrence ,   the HVTN 703/HPTN 081 Team
Published: February 2021

Background:

HIV Vaccine Trials Network 703/HIV Prevention Trials Network 081 is a phase 2b randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of passively infused monoclonal antibody VRC01 in preventing HIV acquisition in heterosexual women between the ages of 18 and 50 years at risk of HIV. Participants were enrolled at 20 sites in Botswana, Kenya, Malawi, Mozambique, South Africa, Tanzania, and Zimbabwe. It is one of the 2 Antibody Mediated Prevention efficacy trials, with HIV Vaccine Trials Network 704/HIV Prevention Trials Network 085, evaluating VRC01 for HIV prevention.

Methods:

Intense community engagement was used to optimize participant recruitment and retention. Participants were randomly assigned to receive intravenous VRC01 10 mg/kg, VRC01 30 mg/kg, or placebo in a 1:1:1 ratio. Infusions were given every 8 weeks with a total of 10 infusions and 104 weeks of follow-up after the first infusion.

Results:

Between May 2016 and September 2018, 1924 women from sub-Saharan Africa were enrolled. The median age was 26 years (interquartile range: 22–30), and 98.9% were Black. Sexually transmitted infection prevalence at enrollment included chlamydia (16.9%), trichomonas (7.2%), gonorrhea (5.7%), and syphilis (2.2%). External condoms (83.2%) and injectable contraceptives (61.1%) were the methods of contraception most frequently used by participants. In total, through April 3, 2020, 38,490 clinic visits were completed with a retention rate of 96% and 16,807 infusions administered with an adherence rate of 98%.

Conclusions:

This proof-of-concept, large-scale monoclonal antibody study demonstrates the feasibility of conducting complex trials involving intravenous infusions in high incidence populations in sub-Saharan Africa.
AIDS Malignancy Consortium 054: Safety and Immunogenicity of the Quadrivalent Vaccine in Indian Women Living With HIV
Authors: Palefsky Joel M. , Poongulali Selvamuthu , Lensing Shelly , Lee Jeannette , Da Costa Maria , Chein Aung , Beulah Faith , Murugavel K. G. , Kumarasamy Nagalingeswaran
Published: February 2021

Background:

Human papillomavirus (HPV)-associated cervical cancer is a leading cause of death among Indian women. Indian women living with HIV (WLWH) may be at especially high risk. The quadrivalent HPV (qHPV) vaccine is effective in prevention of initial infection with HPV-6/11/16/18 in HIV-negative women. Little is known about previous exposure to HPV-6/11/16/18, safety, and immunogenicity of qHPV in Indian WLWH.

Methodology:

One hundred fifty WLWH with different CD4 levels and HIV viral load (VL) were vaccinated at 0/2/6 months at CART-CRS-IDMC, Chennai, India. Serology was performed at weeks 0, 28, and 52 for HPV-6/11/16/18 using a competitive Luminex immunoassay and for HPV-16/18 using a pseudovirion-based neutralization assay.

Results:

Mean age was 30.8 years (range, 19–44 years). 71/87/73/81% of women were naive (sero-negative and DNA-negative) to HPV-6/11/16/18 at baseline, respectively. Among per-protocol women naive to HPV-6/11/16/18 at baseline, 100/99/99/90%, respectively, seroconverted at week 28 and 95/96/98/71% were sero-positive at week 52, respectively. Pseudovirion-based neutralization assay identified more seroconversion to HPV-18 than competitive Luminex immunoassay. There were no significant differences in the proportion seroconverting by baseline or nadir CD4 or HIV VL; however, there was a trend for increased proportion seroconverting to HPV-18 among women with higher baseline CD4 level (P = 0.052). There were no qHPV-related serious adverse events and no change in CD4 level or HIV VL among women on ART.

Conclusions:

qHPV vaccine was safe and immunogenic in Indian WLWH. A high proportion were naive to HPV-6/11/16/18 and may benefit from vaccination although many were married and several years post-initiation of sexual activity.
Optimal Time Point for 68Ga-PSMA-11 PET/CT Imaging in the Assessment of Suspected Metastatic Prostate Cancer in the Bladder of Postprostatectomy Patient
Authors: Xu Guofan , Lu Yang
Published: February 2021

A 77-year-old man with prostate cancer had prostatectomy and hormonal therapy and underwent pelvic MRI and 68Ga-PSMA-11 PET/CT during clinical follow-up. A pelvic MRI scan showed suspected metastasis along the posterior wall of urinary bladder. The 68Ga-PSMA-11 PET/CT was acquired in a dual-time point fashion, at 60 minutes and 110 minutes postinjection. At 60 minutes postinjection, the known bladder wall lesion showed lower than urine background uptake. On 110 minutes delayed images, the bladder wall lesion showed avid PSMA uptake, much higher than the urine background, increased PSMA uptake by the tumor over time, and improved contrast in the lesion.
Approach to Fronto-Orbital Sequelae in Anterior Synostotic Plagiocephaly: Our Flow Chart Based on Di Rocco Classification
Authors: Saponaro Gianmarco , Pelo Sandro , Gasparini Giulio , Todaro Mattia , Cerbellli Edoardo , Moro Alessandro , Doneddu Piero
Published: February 2021

Introduction:

Anterior synostotic plagiocephaly recognizes the synostosis of one of the hemicoronal sutures as a cause and can manifest itself with varying degrees of severity. Clinically it presents a reduction of the sagittal growth of the affected side and flattening of the frontoparietal complex.

Materials and Methods:

The authors retrospectively examined our case sample dividing it into 3 groups based on the Di Rocco classification. For each category, we assessed the extent of facial alterations at the end of skeletal growth and retrospectively analyzed the surgical options aimed at correcting aesthetic and skeletal deficits.

Results:

The authors found that predictable results could be obtained by standardizing the surgical procedure based on Di Rocco's classification groups; in particular, the authors achieved satisfactory results by assigning a specific surgical procedure to each class.
Preliminary Application of Three-Dimensional Printing Technique in Preoperative Localization of Meningioma in Primary Hospitals
Authors: Chen Zheng , Han Xinyu , Fan Gangxian , Liu Pengfei , Wang Qingbo , Li Zhenzhu , Li Meng , Sun Qikai , Li Chenglong , Li Zefu
Published: February 2021

Objective:

To explore the preliminary application of three-dimensional (3D) printing technique in preoperative localization of meningiomas in primary hospitals.

Patients and Methods:

The enrolled subjects were 13 patients in the Department of Neurosurgery, Affiliated Hospital of Binzhou Medical College, Shandong Province between December 2018 and June 2020, including CT or MRI data from eight cases of brain meningiomas and five cases of cerebrospinal meningiomas. The Mimics 17.0 software package was applied to reconstruct the 3D images and print out the 3D guide. The authors placed the 3D printed guide on the surgical area for preoperative tumor location.

Results:

The 3D printed guides for all patients were successfully designed and printed out. Simpson grade I resection was performed on all tumors. No significant hematoma, brain edema, or neurological symptoms were observed in the postoperative patients, and the surgical results were good.

Conclusions:

The authors can use 3D printing technology for precise preoperative localization of meningiomas. Grassroots hospitals can also use this technique because of its economic, accurate, and personalized characteristics.
Risk Factors of Fistula Following Primary Palatoplasty
Authors: Saothonglang Kaweesak , Punyavong Pattama , Winaikosol Kengkart , Jenwitheesuk Kamonwan , Surakunprapha Palakorn
Published: February 2021

Background:

Oronasal fistula (ONF) is a common complication following cleft palate surgery. This study aims to determine the prevalence of ONF and the factors that influence development of ONF following primary palatoplasty.

Materials and Methods:

There were 234 patients undergoing primary palatoplasty during 2012 to 2016 included in this cross-sectional study. Patient demographics, surgeon's experience, age at the time of primary palatoplasty, cleft type by Veau classification, cleft width, and operative technique were recorded. The prevalence of fistulae was the primary outcome. Association of age at the time of repair, cleft type, cleft associated with syndromes, cleft width, and surgeon's experience with fistula rate were secondary outcomes.

Results:

There were 234 consecutive patients (128 boys [54.7%] and 106 girls [45.3%]). The mean age at primary palatoplasty was 13 months. Oronasal fistulae occurred in 61 (26.07%) patients. There was a statistically significant association between postoperative oronasal fistulae and the following independent variables: Veau classification (adjusted odds ratio 2.1; 95% confidence interval [CI] = 1.45–3.1, P < 0.01), cleft associated with syndromes (adjusted odds ratio 4.76; 95% CI = 1.48–15.2, P < 0.01) and cleft width more than 11.5 mm (adjusted odds ratio 1.96; 95% CI = 1.00–3.85, P = 0.04).

Conclusion:

The overall number of fistulae was moderate in patients who had undergone primary palatoplasty in our center. Cleft severity as defined by the Veau classification, cleft width, and cleft associated with syndromes were predictive factors for development of postoperative fistulae.
Variational Characteristics of Nasolabial Appearance and Its Influencing Factors for the Unilateral Cleft Lip Repair With Modified Huaxi Technique
Authors: Wang Fang , Liu Tao , Wang Chao , Song Qinggao
Published: February 2021

Purpose:

After many years in clinical practice, the authors found that the long-term aesthetics of the upper lip and nose following repair of a unilateral cleft lip deformity using the Huaxi method remained unsatisfactory. The immediate postoperative effect was often good, while the long-term postoperative effect was poor. Therefore, this study aimed to evaluate the characteristics and influencing factors of a modified Huaxi method for repairing unilateral cleft lip over time, and to explore the relationship between immediate and long-term outcomes after cleft lip surgery.

Methods:

Patients with unilateral cleft lip who visited the Department of Maxillofacial Surgery of the Stomatological Hospital of Zunyi Medical University from June 2014 to March 2016 were selected. The study group consisted of 51 consecutive patients (30 boys and 21 girls), aged between 3 months and 2 years. Of these, 24 presented with complete unilateral cleft lip (12 wore a nasoalveolar mold as required, 12 did not) and 27 with incomplete unilateral cleft lip (13 wore a nasoalveolar mold as required, 14 did not). Photographs were taken of 51 patients before surgery and immediately, 7 days, and 6 months postoperatively. Various indexes of nasolabial contour of each patient were measured using iWitness photogrammetry, and the slit width; lip height ratio, lip width ratio, nostril width ratio, and nostril height ratio of the healthy side; and degree of deviation of the nasal columella were calculated.

Results:

Long-term symmetry of lip height and width remained stable postoperatively (P > 0.05), whereas nostril height symmetry was significantly reduced (P > 0.05). Nasal width symmetry and midpoint deviation of the nasal columella were stable in patients with nasoalveolar molding (P > 0.05), but significantly decreased in patients without nasoalveolar molding (P < 0.05). In patients with complete unilateral cleft lip, there was a significant correlation between fissure width and lip width symmetry 6 months postoperatively (r = 0.431,P < 0.05).

Conclusions:

The symmetry of the upper lip is satisfactory and stable following surgical repair with the modified Huaxi technique. However, undercorrection of nasal symmetry is commonplace. Fissure width and nasoalveolar molding may influence long-term aesthetics following unilateral cleft lip repair.
Obinutuzumab in Kidney Transplantation: Effect on B-cell Counts and Crossmatch Tests
Authors: NasrAllah Mohamed M. , Elalfy Mahmoud , El Ansary Mervat , Elmeseery Yasser , Amer Ihab , Malvezzi Paolo , Rostaing Lionel
Published: February 2021

Background.

Resistance to the action of rituximab (RTX) has been documented in several diseases. More recently, obinutuzumab (OBZ) has shown promise where RTX has failed in oncology and lupus nephritis. Unlike RTX, OBZ is a weak activator of complement, which may avoid the false-positive complement-dependent cytotoxicity (CDC) crossmatch tests after RTX infusions.

Methods.

The aim of this study was to explore the effect of OBZ on B-cell depletion in kidney-transplant candidates and its impact on crossmatch test results. We included 12 patients, who were either highly sensitized kidney-transplant candidates or kidney-transplant recipients presenting with antibody-mediated rejection. Six received OBZ, and 6 received RTX. CD-19 counts, flow cytometry, and CDC crossmatch tests were run immediately before and at 2 wk after drug infusion.

Results.

OBZ reduced CD-19 counts: median reduction was 98%. B-cell CDC crossmatch test results became positive following RTX infusion but were not affected by OBZ infusion.

Conclusions.

OBZ effectively depleted B-cell counts in sensitized kidney-transplant candidates and, unlike RTX, had no effect on CDC crossmatch results.
Frailty of the Heart Recipient
Authors: Macdonald Peter
Published: February 2021

Frailty has been defined as a state of increased vulnerability due to a decline in the reserve and function of multiple physiological systems. Initially conceived as a geriatric syndrome indicative of physiological aging, it is now apparent that frailty can also be observed as a manifestation of chronic disease states including heart failure. Estimates of the prevalence of frailty in heart failure vary according to the age of the study population and the frailty instrument used; however, multiple studies have identified frailty to be prevalent in patients with advanced heart failure including those who are referred for heart transplantation. Frailty is emerging as an independent predictor of mortality both before and after bridge-to-transplant ventricular assist device implantation and heart transplantation. Frailty is also predictive of prolonged hospitalization following these procedures. Heart failure–associated frailty is a dynamic state. While reversibility of frailty can be anticipated in younger heart failure patients, predicting the reversibility of frailty is more challenging in older patients who often have multiple comorbidities that may contribute to the frailty syndrome. Prehabilitation is a promising approach to both preventing and reversing frailty however more research is urgently needed to establish its effectiveness in mitigating the adverse impacts of frailty on postventricular assist device and posttransplant morbidity and mortality.
Normal breathing releases SARS-CoV-2 into the air
Authors: Di Carlo Piero , Falasca Katia , Ucciferri Claudio , Sinjari Bruna , Aruffo Eleonora , Antonucci Ivana , Di Serafino Alessandra , Pompilio Arianna , Damiani Verena , Mandatori Domitilla , De Fabritiis Simone , Dufrusine Beatrice , Capone Emily , Chiacchiaretta Piero , Brune William H. , Di Bonaventura Giovanni , Vecchiet Jacopo
Published: February 2021

This study tests the release of SARS-CoV-2 RNA into the air during normal breathing, without any sign of possible risk of contagion such as coughing, sneezing or talking. Five patients underwent oropharyngeal, nasopharyngeal and salivary swabs for real-time reverse transcriptase PCR (RT-PCR) detection of SARS-CoV-2 RNA. Direct SARS-CoV-2 release during normal breathing was also investigated by RT-PCR in air samples collected using a microbiological sampler. Viral RNA was detected in air at 1 cm from the mouth of patients whose oropharyngeal, nasopharyngeal and salivary swabs tested positive for SARS-CoV-2 RNA. In contrast, the viral RNA was not identified in the exhaled air from patients with oropharyngeal, nasopharyngeal and salivary swabs that tested negative. Contagion of SARS-CoV-2 is possible by being very close to the mouth of someone who is infected, asymptomatic and simply breathing.
Practical strategies for SARS-CoV-2 RT-PCR testing in resource-constrained settings
Authors: Muller Meredith S. , Chhetri Srijana Bhattarai , Basham Christopher , Rapp Tyler , Lin Feng-Chang , Lin Kelly , Westreich Daniel , Cerami Carla , Juliano Jonathan J. , Lin Jessica T.
Published: February 2021

Backgroun

Standard nasopharyngeal swab testing for SARS-CoV-2 detection by PCR is not always feasible due to limitations in trained personnel, personal protective equipment, swabs, PCR reagents, and access to cold chain and biosafety hoods.

Method

We piloted the collection of nasal mid-turbinate swabs amenable to self-testing, including both standard polyester flocked swabs as well as 3D printed plastic lattice swabs, placed into either viral transport media or an RNA stabilization agent. Quantitative SARS-CoV-2 viral detection by RT-qPCR was compared to that obtained by nasopharyngeal sampling as the reference standard. Pooling specimens in the lab versus pooling swabs at the point of collection was also evaluated.

Results

Among 275 participants, flocked nasal swabs identified 104/121 individuals who were PCR-positive for SARS-CoV-2 by nasopharyngeal sampling (sensitivity 87%, 95% CI 79-92%), mostly missing those with low viral load (<10^3 viral copies/uL). 3D-printed nasal swabs showed similar sensitivity. When nasal swabs were placed directly into an RNA stabilizer, the mean 1.4 log decrease in viral copies/uL compared to nasopharyngeal samples was reduced to <1 log, even when samples were left at room temperature for up to 7 days. Pooling sample specimens or swabs both successfully detected samples >102viral copies/uL.

Conclusions

Nasal swabs are likely adequate for clinical diagnosis of acute infections to help expand testing capacity in resource-constrained settings. When collected into an RNA preservative that also inactivates infectious virus, nasal swabs yielded quantitative viral loads approximating those obtained by nasopharyngeal sampling.
Causal effects from non-alcoholic fatty liver disease on kidney function: A Mendelian randomization study
Authors: Park Sehoon , Lee Soojin , Kim Yaerim , Cho Semin , Kim Kwangsoo , Kim Yong Chul , Han Seung Seok , Lee Hajeong , Lee Jung Pyo , Joo Kwon Wook , Lim Chun Soo , Kim Yon Su , Kim Dong Ki
Published: February 2021

Background & aims

An observational association between nonalcoholic fatty liver disease (NAFLD) and kidney function impairment has been reported. A genetic variant linked to an increased risk of NAFLD, the G allele of rs738409, has been reported to be associated with a reduction in estimated glomerular filtration rate (eGFR).

Approach & Results

In this Mendelian randomization (MR) study, we first performed single-variant MR with rs738409 as a genetic instrument to predict NAFLD. Another genetic instrument was developed from a previous genome-wide association study for the NAFLD phenotype in the Million Veteran Program cohort among individuals of European ancestry (68,725 cases and 95,472 controls). The eGFR outcome was assessed in individuals of white British ancestry included in the UK Biobank (N = 321,405). Further, the associations were reassessed in two negative control subgroups (body mass index < 25 kg/m2 and serum alanine aminotransferase level < 20 IU/mL) with a low probability of developing NAFLD. As a replication analysis, a summary-level MR was performed with the European ancestry CKDGen dataset (N = 567,460). In the UK Biobank dataset, a genetic predisposition for NAFLD, either by rs738409 or a group of variants, was significantly associated with a reduced eGFR even with adjustment for major metabolic disorders. Although the associations were not significant in the negative control subgroups with a low probability of developing NAFLD, they were significant in the subgroups with a remaining risk of NAFLD, suggesting the absence of a horizontal pleiotropic pathway. The summary-level MR from the CKDGen dataset supported the causal effects of NAFLD on reduced eGFR.

Conclusions

This MR analysis supports the causal reduction in kidney function by NAFLD.
Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso
Authors: Valia Daniel , Ingelbeen Brecht , Kaboré Bérenger , Karama Ibrahima , Peeters Marjan , Lompo Palpouguini , Vlieghe Erika , Post Annelies , Cox Janneke , de Mast Quirijn , Robert Annie , van der Sande Marianne A.B. , Villalobos Hector Rodriguez , van der Ven Andre , Tinto Halidou , Jacobs Jan
Published: February 2021

Background

In low- and middle-income countries (LMIC), the prevalence of antimicrobial resistance (AMR) is increasing. WHO recommends monitoring antibiotic use, in particular Watch antibiotics, clinical important but at risk of becoming ineffective due to increasing AMR. We investigated antibiotic use at primary care or community-level in rural Burkina Faso.

Methods

During 2016-2017, patients aged >3 months admitted with severe acute fever to the rural hospital of Nanoro Health District, Burkina Faso, reported antibiotic use in the two weeks prior to consultation or hospitalization, which we analysed using the WHO Access, Watch, Reserve (AWaRe) classification. Most Watch antibiotics, e.g. ceftriaxone, are not recommended at primary health center level, as is also the case for ciprofloxacin in children.

Results

Of 920 participants (63.0% ≤14 years), pre-admission antibiotic use was reported by 363 (39.5%) of whom 58 (16.0%) reported more than one antibiotic. Use was more frequent among health center referrals (231, 54.0%) than among self-referred patients (131, 26.7%, p<0.001). Of 424 antibiotics, 261 (61.6%) were Access and 159 (37.5%) Watch antibiotics. Watch antibiotics use was more frequent among >14 year olds (72, 51.1%) than 0-14 year olds (87, 30.7%) and among referrals (41, 28.1%) compared to self-referred patients (117, 42.2%). Most frequently used Watch antibiotics were ceftriaxone (114, 26.9%) and ciprofloxacin (32, 7.5%). Among antibiotics reported by referral patients, ceftriaxone and ciprofloxacin were respectively recorded 100 (36.1%) and 12 times (4.3%).

Conclusion

The frequent use of Watch group antibiotics prior to presentation to the hospital in rural Burkina Faso highlights the need to address primary care, over-the-counter and informal community-level antibiotic use as part of antibiotic stewardship in LMIC, facilitating referral, access to qualified prescribers, or improving diagnostic tools in health centers.
Modelling seeding and neuroanatomic spread of pathology in amyotrophic lateral sclerosis
Authors: Pandya Sneha , Maia Pedro D. , Freeze Benjamin , Menke Ricarda A L , Talbot Kevin , Turner Martin R , Raj Ashish
Published: February 2021

The neurodegenerative disorder amyotrophic lateral sclerosis (ALS) is characterized by the progressive loss of upper and lower motor neurons, with pathological involvement of cerebral motor and, additionally, extra-motor areas, in a clinicopathological spectrum with frontotemporal dementia (FTD). A key unresolved question is whether the distribution of pathology in ALS is driven by molecular factors such as regional gene expression, by differential network vulnerability, or is a combination of both. A system of histopathological staging of ALS based on the regional burden of TDP-43 pathology observed inpost mortembrains has been supported to some extent by analysis of distribution ofin vivostructural MRI changes. In this paper, computational modelling using a Network Diffusion Model (NDM) was used to investigate whether a process of focal pathological ‘seeding’ followed by structural network-based spread recapitulatedpost mortemhistopathological staging and, secondly, whether this had any relationship to the pattern of expression of a panel of genes implicated in ALS across the healthy brain. Regionally parcellated T1-weighted MRI data from ALS patients (baseline n=79) was studied in relation to a healthy control structural connectome and a database of associated regional cerebral gene expression. The NDM provided strong support for a structural network-based basis for regional pathological spread in ALS, but no simple relationship to the spatial distribution of ALS-related genes in the healthy brain. Intriguingly, the critical seed regions for spread within the model were not within the primary motor cortex but basal ganglia, thalamus and insula, where NDM recapitulated aspects of thepost mortemhistopathological staging system. Within the ALS-FTD clinicopathological spectrum, non-primary motor structures may be among the earliest sites of cerebral pathology.
The Origins and Drivers of Neotropical Diversity
Authors: Meseguer Andrea S. , Michel Alice , Fabre Pierre-Henri , Pérez-Escobar Oscar A. , Chomicki Guillaume , Riina Ricarda , Antonelli Alexandre , Antoine Pierre-Olivier , Delsuc Frédéric , Condamine Fabien L.
Published: February 2021

The origins and evolution of the outstanding Neotropical biodiversity are still debated. A comprehensive understanding is hindered by the lack of deep-time comparative data across wide phylogenetic and ecological contexts. Here, we evaluate four evolutionary scenarios assuming different diversification trajectories and drivers of Neotropical diversification, and assess their variation across Neotropical regions and taxa. Our analysis of 150 phylogenies (12,512 species) of seed plants and tetrapods reveals that Neotropical diversity has mostly expanded through time (70% of the clades), while scenarios of saturated and declining diversity also account for 21% and 9% of Neotropical diversity, respectively. We identify five biogeographic areas that represent distinctive units of long-term Neotropical evolution (Pan-Amazonia, Dry Diagonal, Bahama-Antilles, Galapagos, and an ‘elsewhere’ region) and find that diversity dynamics do not differ across these areas, suggesting no geographic structure in long-term Neotropical diversification. In contrast, diversification dynamics differ substantially across taxa: plant diversity mostly expanded through time (88%), while a substantial fraction (43%) of tetrapod diversity accumulated at a slower pace or declined toward the present. These opposite evolutionary patterns may reflect different capacities for plants and tetrapods to cope with climate change, with potential implications for future adaptation and ecosystem resilience.
Late-life fitness gains explain the absence of a selection shadow in ants
Authors: Nino Luisa M. Jaimes , Heinze Jürgen , Oettler Jan
Published: February 2021

A key hypothesis for the occurrence of senescence is a decrease in the selection strength because of low late-life fitness – the so-called selection shadow. However, in social insects, aging is considered a plastic trait and senescence seems to be absent. By life-long tracking of 102 ant colonies, we find that queens increase the production of sexuals in late life regardless of their absolute lifespan or worker investment. This indicates a genetically accommodated adaptive shift towards increasingly queen-biased caste ratios over the course of a queens’ life. Furthermore, mortality decreased with age, supporting the hypothesis that aging is adaptive. We argue that selection for late life reproduction diminishes the selection shadow of old age and leads to the apparent absence of senescence in ants, in contrast to most iteroparous species.

Significance Statement

Social insects are extraordinary with regard to the absolute age of queens of some species as well as the age differences between queens and short-lived workers. Yet, ultimate causes explaining these aging patterns remain poorly understood. By manipulating the investment ratio into queens and workers we studied the effect on lifespan and temporal reproductive investment of queens. We show that queens shift to the production of sexuals late in life, independent of social context (colony size) or individual quality (reproductive output and lifespan). Such late fitness gains result in maintenance in the selection strength with age, and thus explains the absence of senescence in queens.
Comparison study of sixteen differential abundance testing methods using two large Parkinson disease gut microbiome datasets
Authors: Wallen Zachary D.
Published: February 2021

Background

When studying the relationship between the microbiome and a disease, a common question asked is what individual microbes are differentially abundant between a disease and healthy state. Numerous differential abundance (DA) testing methods exist and range from standard statistical tests to methods specifically designed for microbiome data. Comparison studies of DA testing methods have been performed, but none were performed on microbiome datasets collected for the study of real, complex disease. Due to this, we performed DA testing of microbial genera using 16 DA methods in two large, uniformly collected gut microbiome datasets on Parkinson disease (PD), and compared their results.

Results

Pairwise concordances between methods ranged from 46%-99% similarity. Average pairwise concordance per dataset was 76%, and dropped to 62% when taking replication of signals across datasets into account. Certain methods consistently resulted in above average concordances (e.g. Kruskal-Wallis, ALDEx2, GLM with centered-log-ratio transform), while others consistently resulted in lower than average concordances (e.g. edgeR, fitZIG). Overall, ∼80% of genera tested were detected as differentially abundant by at least one method in each dataset. Requiring associations to replicate across datasets reduced significant signals by almost half. Further requirement of signals to be replicated by the majority of methods (≥8) yielded 19 associations. Only one genus (Agathobacter) was replicated by all methods. Use of hierarchical clustering revealed three groups of DA signatures that were (1) replicated by the majority of methods and included genera previously associated with PD, (2) replicated by few or no methods, and (3) replicated by a subset of methods and included rarer genera, all enriched in PD.

Conclusions

Differential abundance tests yielded varied results. Using one method on one dataset may find true associations, but may also detect non-reproducible signals, adding to inconsistency in the literature. To help lower false positives, one might analyze data with two or more DA methods to gauge concordance, and use a built-in replication dataset to show reproducibility. This study corroborated previously reported microorganism associations in PD, and revealed a potential new group of microorganisms whose abundance is significantly elevated in PD, and might be worth pursuing in future investigations.
SIMILE enables alignment of fragmentation mass spectra with statistical significance
Authors: Treen Daniel G.C. , Northen Trent R. , Bowen Benjamin P.
Published: February 2021

Interrelating compounds according to their aligned fragmentation spectra is central to tandem mass spectrometry-based metabolomics. However, current alignment algorithms do not provide statistical significance and compounds that have multiple delocalized structural differences often fail to have their fragment ions aligned. Significant Interrelation of MS/MS Ions via Laplacian Embedding (SIMILE) is a new tool inspired by protein sequence alignment for aligning fragmentation spectra with statistical significance and allowance for multiple chemical differences. We found SIMILE yields 550% more pairs of structurally similar compounds than commonly used cosine-based scoring algorithms, and anticipate SIMILE will fill an important role by also providing p-values for fragmentation spectra alignments to explore structural relationships between compounds.
Identification of biomarkers and candidate inhibitors for multiple myeloma
Authors: Gu Hanming , Wang Wei , Yuan Gongsheng
Published: February 2021

Multiple myeloma (MM) is a plasma cell malignancy that causes the overabundance of monoclonal paraprotein (M protein) and organ damages. In our study, we aim to identify biological markers and processes of MM using a bioinformatics method to elucidate their potential pathogenesis. The gene expression profiles of the GSE153626 datasets were originally produced by using the high-throughput Illumina HiSeq 4000 (Mus musculus). The functional categories and biochemical pathways were identified and analyzed by the Kyoto Encyclopedia of Genes and Genomes pathway (KEGG), Gene Ontology (GO), and Reactom enrichment. KEGG and GO results showed the biological pathways related to immune dysfunction and signal transduction are mostly affected in the development of MM. Moreover, we identified several genes including Gngt2, Foxp3, and Cd3g were involved in the regulation of immune cells. We further predicted new inhibitors that have the ability to block the progression of MM based on the L1000fwd analysis. Therefore, this study provides further insights into the underlying pathogenesis of MM.
Modeling of fuel flow-rate of commercial aircraft for the descent flight using particle swarm optimization
Authors: Oruc Ridvan , Baklacioglu Tolga
Published: February 2021

Purpose

The purpose of this paper is to create a new fuel flow rate model for the descent phase of the flight using particle swarm optimization (PSO).

Design/methodology/approach

A new fuel flow rate model was developed for the descent phase of the B737-800 aircraft, which is frequently used in commercial air transport using PSO method. For the analysis, the actual flight data records (FDRs) data containing the fuel flow rate, speed, altitude, engine speed, time and many more data were used. In this regard, an empirical formula has been created that gives real fuel flow rate values as a function of altitude and true airspeed. In addition, in the fuel flow rate predictions made for the descent phase of the specified aircraft, a different model has been created that can be used without any optimization process when FDR data are not available for a specific aircraft take-off weight condition.

Findings

The error analysis applied to the models showed that both models predict real fuel flow rate values with high precision.

Practical implications

Because of the high accuracy of the PSO model, it is thought to be useful in air traffic management, decision support systems, models used for trajectory prediction, aircraft performance models, strategies used to reduce fuel consumption and emissions because of fuel consumption.

Originality/value

This study is the first fuel flow rate model for descent flight using PSO algorithm. The use of real FDR data in the analysis shows the originality of this study.
Impacts of monetary instruments on overnight spread under the interest rate corridor framework: evidence from China
Authors: Chang Chiu-Lan , Fang Ming , Hong Bin , Ho Kung-Cheng
Published: February 2021

Purpose

To verify the effectiveness of the monetary policy, the impacts of monetary instruments on overnight spread under the interest rate corridor (IRC) are examined. The People's Bank of China (PBC) has operated the IRC since 2014. To understand the impacts of monetary instruments on overnight spread before and after the IRC framework, the complete samples are divided into two periods.

Design/methodology/approach

To model the overnight spread, an exponential GARCH (EGARCH) approach is used which can examine the interbank market interest rates for monetary policy purposes. The overnight money market plays an important role in the implementation of monetary policy.

Findings

Chinese interest rate liberalization and the implementation of IRC affect the overnight spread in the short-term financing market. Before the implementation of the IRC, the key factor to affect the overnight spread is mainly affected by the PBC's monetary policy control on the liquidity supply side. After the implementation of IRC, the overnight spread can be the largest part explained by the liquidity demand side and the PBC's multiple monetary instruments have significant impacts on the reduction of overnight spread.

Originality/value

The overnight spread has recently been influenced by various factors that are directly or closely related to the monetary policy instruments and the interest rate policy of the PBC. Chinese interest rate liberalization and the implementation of interest rate corridor policy affect the overnight spread in the short-term financing market.
Lighting up Lives Through Cooking Gas1
Authors: Barua Samir Kumar , Agarwalla Sobhesh Kumar
Published: February 2021

The case recounts a significant attempt at social transformation through a simple mechanism of providing cooking gas to the marginalised in society. Targeting about 100 million households in India that still use dung cakes, firewood and coal as the primary fuel for cooking, the government conceived the Pradhan Mantri Ujjwala Yojana1 (PMUY) to replace these traditional fuels with liquefied petroleum gas (LPG), a clean fuel. The government increased the initial target of providing 50 million below poverty line (BPL) families with LPG at the time of scheme launch on May 1, 2016, to 80 million by 2019–20. The scheme had already covered more than 30 million families by January 2018.
Multiple-input multiple-output antenna for dual-band applications with a novel radiating patch and enhanced feeding network
Authors: Zehforoosh Yashar , Alemi Payam
Published: February 2021

Purpose

An Elephant trunk shape (ETS) radiating element is used to achieve the two covering bands of multi-input multi-output (MIMO) antenna. These frequency bands can be controlled by the length of a slot embedded in ETS. The slot length in ETS plays a defining role in controlling the impedance bandwidth (IBW) of the MIMO antenna, and its diligent adjustment of it leads to cover the frequency range of Bluetooth and Wireless Local Area Network systems.

Design/methodology/approach

A new MIMO antenna is introduced in this paper in conjunction with an enhanced Wilkinson power divider feeding platform.

Findings

These frequency bands can be controlled by the length of a slot embedded in ETS. The slot length in ETS plays a defining role in controlling the IBW of the MIMO antenna, and its diligent adjustment leads to covering the frequency range of Bluetooth and WLAN systems.

Originality/value

The proposed MIMO antenna benefits from good isolation between ports for both frequency bands. The proposed MIMO antenna is constructed on FR4 substrate with a volume of 90 × 134 × 1.6 mm3.
Factors influencing scholarly publication productivity: a systematic review
Authors: Wahid Nazia , Warraich Nosheen Fatima , Tahira Muzammil
Published: February 2021

Purpose

The importance of scientific publications has enhanced the research activities at all aggregate levels. The purpose of this paper is to conduct an in-depth review of studies examined the factors that influence the publication productivity among researchers, institutions and countries.

Design/methodology/approach

This paper uses a systematic literature review approach that is based on relevant literature retrieved from two authentic and well-known databases named Web of Science and SCOPUS. Kitchenham protocol of systematic review was applied, and relevant studies were searched by selected keywords search. Inclusion and exclusion criteria were used to select high quality studies. A rigorous study selection procedure was designed.

Findings

Findings reveal that several factors play a significant role in the publication productivity growth. All of the identified factors were grouped into three categories. Most of the factors belong to personal category while two top dominant factors, funding and collaboration fall into situational category. Other most influential factors, time, academic rank and academic qualification are personal. Findings highlight that publication output at individual level is strongly influenced by personal factors while few environmental and situational factors also affect the number of publications. Publication productivity of institutes and countries is affected by environmental and situational factors.

Originality/value

This paper contributes by providing a detailed review to explore the influencing factors of scholarly publication of researchers, institutions and countries. This study will be supportive for researchers and policymakers for making strategies to stimulate the research publication practices at researchers, institutions and national level.