bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Evaluation of Oral Health Status in Healthy Children and Children with Autism Spectrum Disorder
Authors: Tulumbacı Fatih , Korkut Emre , Özer Hazal
Published: April 2020

Objective Autism spectrum disorder (ASD) is regarded a severe neuropsychiatric disorder. The objective of this study was to compare the status of the oral health between children with and without ASDs.

Methods A total of 95 children (44 with ASD and 51 without ASD) were included. dmft/DMFT (d/D: decay; m/M: missing; f/F: filling; t/T: teeth) scores and plaque data of all participants were recorded. Saliva Streptococcus mutans and lactobacilli load were determined using CRT bacteria.

Results Streptococcus mutans load was >105 CFU in 54.5% of the ASD group and 43.1% in the non-ASD group. Lactobacilli load was >105 CFU in 47.70% of the ASD group and 49.0% in the non-ASD group. There was no statistically significant difference in the S. mutans or lactobacilli loads between the ASD and non-ASD groups. A total of 83.1% of the ASD group had caries, with dmft = 3.25 and DMFT = 5.10. In the non-ASD group, 81.10% of patients had caries, with dmft = 3.10 and DMFT = 4.90; 38.6% of the ASD group and 29.4% of the non-ASD group had no clinical signs of periodontal disease.

Conclusion The examination of the amount of saliva S. mutans and lactobacilli at intervals with these patients will provide quantitative data to evaluate the effectiveness of oral health care.
Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction
Authors: Lim Jung-Won , Park Yong-Beom , Lee Dong-Hoon , Lee Han-Jun
Published: April 2020

This study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.
Land and building separation based on Shapley values
Authors: Özdilek Ünsal
Published: April 2020

The total value apportionment between land and building components remains an international issue both in theory and in practice. There are several concepts and methods of value separation, each leading to approximate estimations and therefore to divergent opinions about their reliability. In this paper, we present an alternative method of value apportionment based on Shapley’s scheme of values, well recognized in the coalitional game theory. The practicality of this method is verified using observed prices of 14,715 residential properties sold during the year 2019 over all the 27 districts in Montreal (Canada). This unique data comes with detailed information about the essential attributes of the land and the building components. The empirical results of the method presented in this work are in line with practical expectations of total and separate values, either taken case-by-case or in aggregation per district. They are indeed encouraging when compared to the results of two other independent methods (i.e., the city evaluations and the OLS predictions) for the same properties. The results are interesting not only regarding the separation of value but also in several other related aspects. For instance, land values are often close to or even higher than the building values. This shows a phenomenon of building depreciation and land value appreciation. Some districts seem to favor the quality of the building, others being influenced by the location and quality of the land. Interestingly, in contrast to what is believed in practice, a good quality parcel of land does not necessarily have a good quality building according to the results.
Candidate cases of poecilogony in Neogastropoda: implications for the systematics of the genus Raphitoma Bellardi, 1847
Authors: Russini Valeria , Giannuzzi-Savelli Riccardo , Pusateri Francesco , Prkic Jakov , Fassio Giulia , Modica Maria Vittoria , Oliverio Marco
Published: April 2020

Poecilogony is the intraspecific variation in developmental mode, with larvae of different types produced by the same individual, population or species. It is very rare among marine invertebrates, and in gastropods has long been described only in a few opisthobranchs. The physiological and regulatory mechanisms underlying larval evolutionary transitions, such as loss of planktotrophy that occurred repeatedly in many caenogastropod lineages, are still largely unknown. We have studied the inter- v. intraspecific variation in larval development in the north-east Atlantic neogastropod genus Raphitoma Bellardi, 1847, starting with an iterative taxonomy approach: 17 morphology-based Preliminary Species Hypotheses were tested against a COI molecular-distance-based method (ABGD), and the retained species hypotheses were eventually inspected for reciprocal monophyly on a multilocus dataset. We subsequently performed an ancestral state reconstruction on an ultrametric tree of the 10 Final Species Hypotheses, time-calibrated by fossils, revealing that the interspecific changes were planktotrophy > lecithotrophy, and all have occurred in the Pleistocene, after 2.5 million years ago. This is suggestive of a major role played by Pleistocene Mediterranean oceanographic conditions – enhanced oligotrophy, unpredictable availability of water column resources – likely to favour loss of planktotrophy. Within this group of species, which has diversified after the Miocene, we identified one pair of sibling species differing in their larval development, Raphitoma cordieri (Payraudeau, 1826) and R. horrida (Monterosato, 1884). However, we also identified two Final Species Hypotheses, each comprising individuals with both larval developmental types. Our working hypothesis is that they correspond to one or two poecilogonous species. If confirmed by other nuclear markers, this would be the first documentation of poecilogony in the Neogastropoda, and the second in the whole Caenogastropoda. Although sibling species with different developmental strategies may offer good models to study some evolutionary aspects, poecilogonous taxa are optimally suited for identifying regulatory and developmental mechanisms underlying evolutionary transitions.
Phylogeny, systematics and rarity assessment of New Zealand endemic Saphydrus beetles and related enigmatic larvae (Coleoptera : Hydrophilidae : Cylominae)
Authors: Seidel Matthias , Minoshima Yûsuke N. , Leschen Richard A. B. , Fikácek Martin
Published: April 2020

The New Zealand endemic beetle genus Saphydrus Sharp, 1884 (Coleoptera:Hydrophilidae:Cylominae) is studied in order to understand its phylogenetic position, species-level systematics, biology and distribution, and to reveal reasons for its rarity. The first complete genus-level phylogeny of Cylominae based on two mitochondrial (cox1, 16S) and two nuclear genes (18S, 28S) covering 18 of 19 genera of the subfamily reveals Saphydrus as an isolated lineage situated in a clade with Cylorygmus (South America), Relictorygmus (South Africa) and Eurygmus (Australia). DNA is used to associate two larval morphotypes with Saphydrus: one of them represents the larvae of S. suffusus Sharp, 1884; the other, characterised by unique characters of the head and prothorax morphology, is revealed as sister but not closely related to Saphydrus. It is described here as Enigmahydrus, gen. nov. with a single species, E. larvalis, sp. nov., whose adult stage remains unknown. Saphydrus includes five species, two of which (S. moeldnerae, sp. nov. and S. tanemahuta, sp. nov.) are described as new. Larvae of Enigmahydrus larvalis and Saphydrus suffusus are described and illustrated in detail based on DNA-identified specimens. Candidate larvae for Saphydrus obesus Sharp, 1884 and S. tanemahuta are illustrated and diagnosed. Specimen data are used to evaluate the range, altitudinal distribution, seasonality and population dynamics over time for all species. Strongly seasonal occurrence of adults combined with other factors (winter occurrence in S. obesus, occurrence at high altitudes in S. tanemahuta) is hypothesised as the primary reason of the rarity for Saphydrus species. By contrast, Enigmahydrus larvalis underwent a strong decline in population number and size since the 1970s and is currently known from a single, locally limited population; we propose the ‘nationally threatened’ status for this species. http://zoobank.org/urn:lsid:zoobank.org:pub:28D87163-29E8-418C-9380-262D3038023A
Un essai d’histoire comparée de la grammatisation des langues
romanes
Authors: Fournier Jean-Marie
Published: April 2020

Cet article propose l’étude des connexions observables
entre plusieurs traditions grammaticales nationales dans le
traitement de la morphosyntaxe des noms de masse et de la
détermination partitive à travers un corpus de grammaires
italiennes, espagnoles, portugaises et françaises. Il décrit en
particulier la circulation de quelques-uns des noyaux de
théorisation attachés à ce champ de problèmes dans les grammaires
des langues romanes: l’anomalie des noms qui n’ont pas de pluriel,
la conceptualisation de la catégorie de l’article partitif, la
syntaxe de certains quantifieurs (par exemple mucho
et poco). Les grammairiens affrontent alors des
problèmes de description qui tiennent à la fois au fait que les
phénomènes sont en cours de grammaticalisation au cours de la
période et que leurs solutions ne sont pas données dans le
référentiel théorique mobilisé par la grammaire latine
étendue.
La phrase grammaticale moderne
Authors: Gautier Antoine , Raby Valérie
Published: April 2020

Since the 1970’s, history of linguistics has been called
upon to locate the sources of a deceptively familiar notion: the
grammatical sentence. In this paper, we first
review the main hypotheses regarding the birth act of the notion, we
then question the relationship between two moments that seem crucial
to the development of sentence in French grammatical culture: Urbain
Domergue’s reform of the syntactic analysis, and the new school
grammar that is set up at the beginning of the 20th century.
L’homme dans la langue
Authors: De Palo Marina
Published: April 2020

This paper aims to propose some considerations about the
European Saussurean tradition focusing on the relation between man
and language. It will be argued that, against the current
interpretation of Saussure as a promoter of the linguistique
de la langue, his notes on the speaker’s judgement
about the language and on metalanguage, show a very complex thought.
This fact finds important developments in Karl Bühler’s and Émile
Benveniste’s theories and in their connections with Hendrik J. Pos’
and Maurice Merleau-Ponty’s phenomenology.
The history of language learning and teaching (HoLLT) in the
history of linguistics
Authors: McLelland Nicola
Published: April 2020

Fifty years after two of the first overviews of the
history of language teaching (Titone 1968, Kelly
1969), this paper highlights the value of the history of language learning and teaching (HoLLT) to the history of
linguistics, from three perspectives: (1) theoretical and descriptive
insights; (2) insights into practice (e.g. changing conceptions and
articulations of what it means to learn a language, reflecting
changing language ideologies); and (3) making space in the history of
linguistics for “history from below” – in particular as learning and
teaching of languages, offered a space for females’ participation in
and visibility in linguistic matters.
Processes of language codification
Authors: Takahashi Hideaki
Published: April 2020

In order to establish a standard variety of language, its norms are more often than not codified in a linguistic code such as in a dictionary of orthography, pronunciation and so on. In this study, codification processes of standard varieties of German pronunciation will be explored by means of the author’s Language Codification Cycle Theory (LCCT). This theory focuses on the management of standard varieties of a language through the codification and realization of certain linguistic forms of model speakers or writers in formal settings. This chapter will illuminate the processes of management underlying standard varieties, categorize the managed linguistic forms and consider their validity in formal settings in German-speaking countries. LCCT can be applied to the analysis and clarification of the processes of language standardization in terms of codification at any level of language structure, such as pronunciation and orthography. Making use of this, we can analyze the interrelation of management at the macro and micro levels, which is one of the important topics in Language Management Theory (LMT).
The bridging role of the researcher between different levels of language management
Authors: Kimura Goro Christoph
Published: April 2020

This paper focuses on the socially oriented activities of the researcher of language management in order to clarify what kind of role these activities can play as part of the overall language management processes that are researched. A research project on interlingual communication at the German-Polish border is analyzed as a case study. The focus is on the process of how the researcher tries to transfer findings from research on micro-level situations to various macro-level decision makers and stakeholders. The consideration of the unique potential of the researcher to bridge different levels suggests that the public engagement of researchers should be recognized as an integral part of application-oriented language management research.
Evaluation of prospective directions of production of fluidics systems
Authors: Davydov A , Zyubin I , Gavryushina O , Sinitsyna A
Published: April 2020

the modern possibilities of manufacturing technologies of pneumatic automation systems based on fluidic switching elements are considered. The perceptivity of using the fluidic systems as the alternative to using the relay automation systems is noted.
Obtaining of the drying time of a vertical cylindrical tank
Authors: Shablovskiy A , Bilenko I , Chadin V , Budarin I , Makhlaeva A , Sivova A
Published: April 2020

The work is devoted to the finding of the formula for calculating the drying time of a vertical cylindrical tank. The structure, applications and main types of this vertical tank and its advantages in comparison to the horizontal tank are described. The figuring out of the formula is based on the method of solving a differential equation of first order for pump capacity (performance), a time-dependent operation of the pump and liquid volume, depending on the height of the decreasing liquid.
Review of two-line hydraulic drive research
Authors: Nikitin O , Zhang He Xuan
Published: April 2020

The article provides a brief overview of literary sources from the PRC on the study of a hydraulic drive with two-line control. This hydraulic drive is a new electro-hydraulic system for regulating the flow of a positive displacement pump, developed on the basis of control systems for the electric motor and the volumetric displacement of an adjustable positive displacement pump. The hydraulic drive has two lines of control variables: the rotational speed of the drive motor shaft and the adjustable displacement of the pump. The composite function of the two control lines allows you to create a hydraulic actuator with high efficiency and operating speed. An advanced hydraulic drive with two-line control increases the overall natural frequency of the entire system.
Justification of the concept of creating a perspective dump truck
Authors: Kartashov A , Harutyunyan G , Kosolapov A , Shkarupelov E
Published: April 2020

Annotation

The article carried out a deep technical and economic analysis of existing samples of quarry vehicles. The modern technical level of the mining industry is determined by performing a patent search and review of literature on this topic. The main problems associated with the operation of mining vehicles in mining are considered. The basic requirements for the development of a perspective dump truck have been formed.
Conceptual features of improving the flow-through parts of gas separators of submersible electric pumps systems f for the production of formation fluid in order to improve the separating properties, energy efficiency and reliability
Authors: Trulev A , Timushev S , Lomakin V
Published: April 2020

This article analyzes the design of the power part of gas separators of various manufacturers, reveals the causes of backflows, which can lead to hydro-abrasive wear of the elements of the flow-through part, reduction of the separation properties as a result of the gas-liquid mixture flow dispersion, and decrease of pressure gradient in the separation chamber. A mathematical model was selected, hydrodynamic calculations of design options and upgrading were carried out, and animproved flow part of the separator was developed. Bench tests were conducted to confirm the improved parameter of the product.
Method for leakage measurement in the recirculation path of a hermetic pump
Authors: Chaburko P , Kuznetsov A
Published: April 2020

The article is devoted to the measurement of leakage in the recirculation path of a hermetic pump. The field of application of hermetic pumps is described. The mathematical model used in computer simulation and the mesh conditions are given. The results of the numerical modeling and the theoretical calculation are presented. The graph of the dependence of the leakage in the recirculation path on the pump head is shown. The scalar scenes of velocities and pressures in the c path are given.
Development and research of a borehole centrifugal pump stage
Authors: Cheremushkin V , Lomakin V , Kalin N , Trulev A
Published: April 2020

This article is devoted to the model of a borehole centrifugal pump developed at the Department of Hydraulics of Bauman Moscow State Technical University. A universal layout has been developed for testing the stages of pumps of this type in a certain range of parameters. The article describes the mathematical model used. A comparison of numerical and field experiments is given. A problem has been identified when comparing their results.
Morphological caste differences in primitively eusocial insects: the Van der Vecht organ ofMischocyttaruspaper wasps
Authors: de Souza André Rodrigues , Baptista Camila Folly , Santos Eduardo Fernando , da Silva Rafael Carvalho , da Silva Prato Amanda , Antonialli-Junior William , Pereira Soares Eva Ramona , Barbosa Bruno Corrêa , do Nascimento Fábio Santos , Lino-Neto José
Published: April 2020

Nests of independent-founding primitively eusocial paper wasps are founded by one or a few females. Before worker emergence, foundresses must forage, sometimes leaving the nest unattended. Chemical defence - the application of ant repellent secretions of the Van der Vecht organ (VdVO) on the nest surface - allows brood protection when active defence is weak or not possible. After worker emergence, it is more likely that some wasps stay in the nest, so active nest defence may be more common. Given this constraint on the nest defence, selection for increasing the cuticular secretory area of the VdVO, to improve chemical defence, may be stronger in foundresses (queens) than in workers - morphological castes are hypothesized to evolve. We investigated the occurrence of morphological castes in the Neotropical paper wasp Mischocyttarus. Confirming our prediction, we found that in some (but not all) species, foundresses have a distinct increase in the secretory area of the VdVO in relation to workers; even though there is a strong overlap between caste phenotypes (incipient morphological castes). Implications of these findings for the evolution of morphological castes in primitively eusocial wasps are discussed.
Kidney manifestations of mild, moderate and severe coronavirus disease 2019: a retrospective cohort study
Authors: Hong Daqing , Long Lin , Wang Amanda Y , Lei Yu , Tang Yun , Zhao Jia Wei , Song Xiaofei , He Yanan , Wen Ergang , Zheng Ling , Li Guisen , Wang Li
Published: April 2020

Background

Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 3 million patients globally. Previous data from Wuhan city showed that acute kidney injury (AKI), proteinuria and hematuria occurred frequently in patients with severe COVID-19. However, the prevalence of kidney injury in milder cases remains unclear.

Methods

This retrospective study included two major consecutive cohorts of COVID-19 patients in Sichuan Province. Baseline characteristics, laboratory data including renal function, proteinuria and dipstick hematuria, and other laboratory parameters were collected. A subgroup of patients was followed up for 2–4 weeks to evaluate the short-term outcome of renal impairment.

Results

Overall, 168 COVID-19-positive patients were included in the study. The majority of patients (79.7%) were diagnosed with mild or moderate disease. Half of patients presented with fever; however, in The Tibetan cohort, fever only occurred in 13.4% of patients. On hospital admission, proteinuria and dipstick hematuria were noted in 18.4% and 17.4% of patients, respectively, while AKI only occurred in one patient. Further analysis showed that severe or critical COVID-19 was associated with higher risk of proteinuria [relative risk (RR) 7.37, 95% confidence interval (CI) 2.45–22.18, P = 3.8 × 10−4] and dipstick hematuria (RR 8.30, 95% CI 2.69–25.56, P = 2.3 × 10−4). Proteinuria, dipstick hematuria, or the combination of proteinuria and hematuria could significantly predict severe or critical severe COVID-19.

Conclusions

Proteinuria and dipstick hematuria are not uncommon in patients with COVID-19 infection, especially in severe or critical cases.
Chest pain without obstructive coronary artery disease: a case series
Authors: Sidik Novalia P , McDermott Michael , McEntegart Margaret B , Berry Colin
Published: April 2020

Background

Ischaemic heart disease is a leading cause of mortality in women. Even in those without obstructive coronary artery disease (CAD), women with angina continue to have increased mortality. There are gender differences in prevalence of different pathophysiologies, including functional disorders such as microvascular and vasospastic angina.

Case summary

We describe four cases of angina in women with no obstructive CAD, in whom coronary function testing was performed. These four patients were diagnosed with disorders of coronary vasomotion, including vasospastic angina and different endotypes of microvascular angina.

Discussion

This case series highlights the different mechanisms of ischaemia in the absence of obstructive CAD. Patients with angina and no obstructive CAD classified by computed tomography coronary angiography may have myocardial ischaemia due to microvascular angina, vasospastic angina, or both. Conventional investigations risk under-diagnosing, and as a consequence under-treating, patients with these conditions. Coronary function testing, in the form of diagnostic guidewire-based tests and adjunctive acetylcholine provocation, has proven to be critical in the accurate diagnoses and appropriate management of these patients.
Unsupervised machine learning and prognostic factors of survival in chronic lymphocytic leukemia
Authors: Coombes Caitlin E , Abrams Zachary B , Li Suli , Abruzzo Lynne V , Coombes Kevin R
Published: April 2020

Objective

Unsupervised machine learning approaches hold promise for large-scale clinical data. However, the heterogeneity of clinical data raises new methodological challenges in feature selection, choosing a distance metric that captures biological meaning, and visualization. We hypothesized that clustering could discover prognostic groups from patients with chronic lymphocytic leukemia, a disease that provides biological validation through well-understood outcomes.

Methods

To address this challenge, we applied k-medoids clustering with 10 distance metrics to 2 experiments (“A” and “B”) with mixed clinical features collapsed to binary vectors and visualized with both multidimensional scaling and t-stochastic neighbor embedding. To assess prognostic utility, we performed survival analysis using a Cox proportional hazard model, log-rank test, and Kaplan-Meier curves.

Results

In both experiments, survival analysis revealed a statistically significant association between clusters and survival outcomes (A: overall survival, P = .0164; B: time from diagnosis to treatment, P = .0039). Multidimensional scaling separated clusters along a gradient mirroring the order of overall survival. Longer survival was associated with mutated immunoglobulin heavy-chain variable region gene (IGHV) status, absent Zap 70 expression, female sex, and younger age.

Conclusions

This approach to mixed-type data handling and selection of distance metric captured well-understood, binary, prognostic markers in chronic lymphocytic leukemia (sex, IGHV mutation status, ZAP70 expression status) with high fidelity.
Bridging the Accountability Gap
Authors: Jöbstl Hannes
Published: April 2020

During non-international armed conflict, war crimes often go unpunished in areas where state authorities are unable to enforce the law. While states are under a customary law obligation to investigate and prosecute war crimes committed on their territory or by their nationals, the Customary International Humanitarian Law Study of the International Committee of the Red Cross has not found that this obligation extends to armed non-state actors (ANSAs). Nevertheless, command responsibility requires the individual commander to punish their forces in case war crimes have been committed and a growing amount of state practice demanding similar commitments — both legally and politically — from these actors as such can be observed over the past two decades. Indeed, ANSAs routinely impose penal sanctions onto their subordinates and often establish judicial structures in order to do so. This article argues that whereas ANSAs should be under some form of obligation to ensure accountability, alternative solutions to makeshift courts and penal proceedings might be better suited to prevent impunity and maintain fair trial guarantees.
Dietary Intake, Hydration Status, and Body Composition of Three Belgian Military Groups
Authors: De Bry William , Mullie Patrick , D’Hondt Eva , Clarys Peter
Published: April 2020

Introduction

Malnutrition, suboptimal hydration, and inadequate body composition can have negative consequences on soldiers’ performance and health. A recent consensus statement concerning “soldiers’ physical performance” points to the scarcity of data in specific military populations. Therefore, the aim of the present study was to assess and compare dietary intake, hydration status, and body composition of three military groups during their specific military training.

Materials and Methods

Eighty-five soldiers (ie, 21 in a qualification course to join the Special Forces [SF], 22 Infantrymen [Chasseurs Ardennais, CA], and 42 Recruits [REs]) participated in this 3- to 4-day study. Body mass was assessed before and after each study period. All soldiers self-reported their dietary intakes, from which energy and macronutrient intakes were calculated. In addition, their morning urine samples were collected daily to assess urine specific gravity (USG) as a measure of hydration status. Fat mass was estimated at the end of the study using bioelectrical impedance analysis.

Results

All groups lost significant amounts of body mass (ie, mean losses ranging between 1.3 and 1.7 kg). Macronutrient intakes were not fully met in respect to the recommendations. Most notably, REs’ fat intake was high (ie, 42.3 [±1.6] energy percent [E%]), while their carbohydrate intake was low (ie, 44.5 [±2.1] E%). Furthermore, saturated fat intakes were high among all groups (ie, group means ranging between 13.6 and 21.4 E%). USG values indicated suboptimal hydration status was prevalent in all groups. Most noteworthy, for SF, only 5.4% of the USG values indicated optimal hydration. The average fat mass (%) for SF, CA, and RE was 11.2 (±3.1), 18.8 (±5.1), and 19.4 (±5.0), respectively.

Conclusion

The present study showed that military men are not always adequately fed nor hydrated. These issues should be resolved by creating nutritional packages, and individual dietary and hydration strategies, all in function of military planning and weather conditions.
High HIV Incidence Among Men Who Have Sex With Men in 8 Chinese Cities: Results From a Trial
Authors: Huang Wenting , Wang Yehua , Lu Haidong , Wu Dan , Pan Stephen W , Tucker Joseph D , Tang Weiming
Published: April 2020

Background

In China, while the overall HIV prevalence has been decreasing within key populations, the epidemic among men who have sex with men (MSM) is still on the rise. This study aims to assess the HIV incidence rate and identify driving forces of HIV seroconversion among MSM in a closed cohort.

Methods

This study is a secondary analysis of a large trial of HIV testing promotion among Chinese MSM in 2016–2017. Sexual behaviors, HIV testing activities, and HIV serostatus were measured at baseline and follow-up every 3 months. HIV seroconversion in this study was defined as a self-reported HIV-positive test result. Participants who reported testing for HIV at least twice during different follow-up periods were included. Subgroup analysis and Cox regression were used to examine the correlates with HIV seroconversion.

Results

Overall, 347 participants were included in this study, with a mean age of 25.3 ± 6.1, and 71.2% were migrants. The sociodemographic characteristics of the included participants were similar to the rest of the participants in the trial (n = 1034); 7.2% (25/347) of participants seroconverted during the study period, resulting in an incidence rate of 15.56/100 person-years. In subgroup analysis, the HIV incidence rate was higher among migrants than nonmigrants (incidence rate ratio, 1.26; 95% confidence interval [CI], 0.47–3.87). In the time-dependent Cox regression model, bisexual MSM had a higher risk of contracting HIV than gay men (adjusted hazard ratio, 2.19; 95% CI, 1.02–4.72).

Conclusions

Our findings suggest a high HIV incidence rate among Chinese MSM. Further expansion of pre-exposure prophylaxis and other effective HIV prevention interventions are urgently needed.
The effect of zolpidem on memory consolidation over a night of sleep
Authors: Zhang Jing , Yetton Ben , Whitehurst Lauren N , Naji Mohsen , Mednick Sara C
Published: April 2020

Study Objectives: Nonrapid eye movement sleep boosts hippocampus-dependent, long-term memory formation more so than wake. Studies have pointed to several electrophysiological events that likely play a role in this process, including thalamocortical sleep spindles (12–15 Hz). However, interventional studies that directly probe the causal role of spindles in consolidation are scarce. Previous studies have used zolpidem, a GABA-A agonist, to increase sleep spindles during a daytime nap and promote hippocampal-dependent episodic memory. The current study investigated the effect of zolpidem on nighttime sleep and overnight improvement of episodic memories. Methods: We used a double-blind, placebo-controlled within-subject design to test the a priori hypothesis that zolpidem would lead to increased memory performance on a word-paired associates task by boosting spindle activity. We also explored the impact of zolpidem across a range of other spectral sleep features, including slow oscillations (0–1 Hz), delta (1–4 Hz), theta (4–8 Hz), sigma (12–15 Hz), as well as spindle–SO coupling. Results: We showed greater memory improvement after a night of sleep with zolpidem, compared to placebo, replicating a prior nap study. Additionally, zolpidem increased sigma power, decreased theta and delta power, and altered the phase angle of spindle–SO coupling, compared to placebo. Spindle density, theta power, and spindle–SO coupling were associated with next-day memory performance. Conclusions: These results are consistent with the hypothesis that sleep, specifically the timing and amount of sleep spindles, plays a causal role in the long-term formation of episodic memories. Furthermore, our results emphasize the role of nonrapid eye movement theta activity in human memory consolidation.
Multiple drivers of the COVID-19 spread: role of climate, international mobility, and region-specific conditions
Authors: Kubota Yasuhiro , Shiono Takayuki , Kusumoto Buntarou , Fujinuma Junichi
Published: April 2020

The novel Coronavirus Disease 2019 (COVID-19) has spread quickly across the globe. Here, we evaluated the role of climate (temperature and precipitation), region-specific susceptibility (BCG vaccination, malaria infection, and elderly population) and international traveller population (human mobility) in shaping the geographical patterns of COVID-19 cases across 1,055 countries/regions, and examined the sequential shift of multiple drivers of the accumulated cases from December, 2019 to April 12, 2020. The accumulated numbers of COVID-19 cases (per 1 million population) were well explained by a simple regression model. The explanatory power (R2) of the model increased up to > 70% in April 2020 as the COVID-19 spread progressed. Climate, host mobility, and host susceptibility largely explained the variance of the COVID-19 cases (per 1 million population), and their explanatory power improved as the pandemic progressed; the relative importance of host mobility and host susceptibility have been greater than that of climate. The number of days from outbreak onset showed greater explanatory power in the earlier stages of COVID-19 spread but rapidly lost its influence. Our findings demonstrate that the COVID-19 pandemic is deterministically driven by climate suitability, cross-border human mobility, and region-specific susceptibility. The present distribution of COVID-19 cases has not reached an equilibrium and is changing daily, especially in the Southern Hemisphere. Nevertheless, the present results, based on mapping the spread of COVID-19 and identifying multiple drivers of this outbreak trajectory, may contribute to a better understanding of the COVID-19 disease transmission risk and the measures against long-term epidemic.
Predicting mortality due to SARS-CoV-2: A mechanistic score relating obesity and diabetes to COVID-19 outcomes in Mexico
Authors: Bello-Chavolla Omar Yaxmehen , Bahena-López Jessica Paola , Antonio-Villa Neftali Eduardo , Vargas-Vázquez Arsenio , González-Díaz Armando , Márquez-Salinas Alejandro , Fermín-Martínez Carlos A. , Naveja J. Jesús , Aguilar-Salinas Carlos A.
Published: April 2020

BACKGROUND

The SARS-CoV-2 outbreak poses challenge to healthcare systems due to high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, including specific factors for diabetes and obesity and its role in improving risk prediction.

METHODS

We obtained data of confirmed and negative COVID-19 cases and their demographic and health characteristics from the General Directorate of Epidemiology of Mexican Ministry of Health. We investigated specific risk factors associated to COVID-19 positivity and mortality and explored the impact of diabetes and obesity on modifying COVID-19 related lethality. Finally, we built a clinical score to predict COVID-19 lethality.

RESULTS

Among 177,133 subjects at May 18th, 2020, we observed 51,633 subjects with SARS-CoV-2 and 5,332 deaths. Risk factors for lethality in COVID-19 include early-onset diabetes, obesity, COPD, advanced age, hypertension, immunosuppression, and CKD; we observed that obesity mediates 49.5% of the effect of diabetes on COVID-19 lethality. Early-onset diabetes conferred an increased risk of hospitalization and obesity conferred an increased risk for ICU admission and intubation. Our predictive score for COVID-19 lethality included age ≥65 years, diabetes, early-onset diabetes, obesity, age <40 years, CKD, hypertension, and immunosuppression and significantly discriminates lethal from non-lethal COVID-19 cases (c-statistic=0.823).

RESULTS

Here, we propose a mechanistic approach to evaluate risk for complications and lethality attributable to COVID-19 considering the effect of obesity and diabetes in Mexico. Our score offers a clinical tool for quick determination of high-risk susceptibility patients in a first contact scenario.
ESTIMATING R0 OF SARS-COV-2 IN HEALTHCARE SETTINGS
Authors: Temime Laura , Gustin Marie-Paule , Duval Audrey , Buetti Niccolò , Crépey Pascal , Guillemot Didier , ThiéBaut Rodolphe , Vanhems Philippe , Zahar Jean-Ralph , Smith David R.M. , Opatowski Lulla
Published: April 2020

To date, no specific estimate of R0 for SARS-CoV-2 is available for healthcare settings. Using inter-individual contact data, we highlight that R0 estimates from the community cannot translate directly to healthcare settings, with pre-pandemic R0 values ranging 1.3-7.7 in three illustrative healthcare institutions. This has implications for nosocomial Covid-19 control.
Estimation of undetected COVID-19 infections in India
Authors: Mukhopadhyay Siuli , Chakraborty Debraj
Published: April 2020

Background and Objectives

While the number of detected COVID-19 infections are widely available, an understanding of the extent of undetected COVID-19 cases is urgently needed for an effective tackling of the pandemic and as a guide to lifting the lockdown. The aim of this work is to estimate and predict the true number of COVID-19 (detected and undetected) infections in India for short to medium forecast horizons. In particular, using publicly available COVID-19 infection data up to 28th April 2020, we forecast the true number of infections in India till the end of lockdown (3rd May) and five days beyond (8th May).

Methods

The high death rate observed in most COVID-19 hit countries is suspected to be a function of the undetected infections existing in the population. An estimate of the age weighted infection fatality rate (IFR) of the disease of 0.41%, specifically calculated by taking into account the age structure of Indian population, is already available in the literature. In addition, the recorded case fatality rate (CFR= 1%) of Kerala, the first state in India to successfully flatten the curve by consistently reporting single digit new infections from 12-20 April, is used as a second estimate of the IFR. These estimates are used to formulate a relationship between deaths recorded and the true number of infections and recoveries. The estimated undetected and detected cases time series based on these two IFR estimates are then used to fit a discrete time multivariate infection model to predict the total infections at the end of the formal lockdown period.

Results

Over three consecutive fortnight periods during the lockdown, it was noted that the rise in detected infections has decreased by 8.2 times. For an IFR of 0.41%, the rise in undetected infections decreased 2.5 times, while for the higher IFR value of 1%, undetected cases decreased by 2.4 times. The predicted number of total infections in India on 3rd May for both IFRs varied from 2.8 - 6.8 lakhs.

Interpretation and Conclusions

The behaviour of the undetected cases over time effectively illustrates the effects of lockdown and increased testing. From our estimates, it is found that the lockdown has brought down the undetected to detected cases ratio, and has consequently dampened the increase in the number of total cases. However, even though the rate of rise in total infections has fallen, the lifting of the lockdown should be done keeping in mind that 2.3 to 6.4 lakhs undetected cases will already exist in the population by 3rd May.
Clinical features of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury
Authors: Rodríguez-Cola Miguel , Jiménez-Velasco Irena , Gutiérrez-Henares Francisco , López-Dolado Elisa , Gambarrutta-Malfatti Claudia , Vargas-Baquero Eduardo , Gil-Agudo Ángel
Published: April 2020

Study design

Cohort study of patients with spinal cord injury (SCI)

Objectives

To describe the clinical and analytical features of a Covid-19 infected cohort with SCI to contribute new knowledge for a more accurate diagnosis and to outline prevention measures.

Setting

This study was conducted at the National Hospital for Paraplegics (Toledo, Spain).

Methods

A cohort analysis of seven patients with SCI infected by Covid-19 was carried out. Diagnosis was confirmed with reverse transcriptase polymerase chain reaction (RT-PCR) of nasal exudate or sputum samples. Clinical, analytical and radiographic findings were registered.

Results

RT-PCR detected COVID-19 infection in all patients, affecting males and people with a cervical level of injury more often (5 out 7). The average delay for diagnostic confirmation was 4 days (interquartile range, 1-10). Fever was the most frequent symptom (6 out of 7). The second most common symptom was asthenia (4 out of 7), followed by dyspnea, cough and expectoration (3 out of 7 for each symptom). The MEWS score for Covid-19 severity rating was classified as severe in 5 out of 7. All but one patient showed radiological alterations evident in chest X-Rays at the time of diagnosis. All patients recovered gradually.

Conclusion

Our patients with SCI and Covid-19 infection exhibited fewer symptoms than the general population. Furthermore, they presented similar or greater clinical severity. The clinical evolution was not as pronounced as had been expected. This study recommends close supervision of the SCI population to detect early compatible signs and symptoms of Covid-19 infection.
Characterization of a high-resolution breath acetone meter for ketosis monitoring
Authors: Suntrup Donald J. , Ratto Timothy V. , Ratto Matt , McCarter James P.
Published: April 2020

Background

The ketone bodies beta-hydroxybutyrate (BHB) and acetone are endogenous products of fatty acid metabolism. Although ketone levels can be monitored by measuring either blood BHB or breath acetone, determining the precise correlation between these two measurement methods has been challenging. The purpose of this study is to characterize the performance of a novel portable breath acetone meter (PBAM) developed by Readout, Inc., to compare single versus multiple daily ketone measurements, and to compare breath acetone (BrAce) and blood BHB measurements.

Methods

We conducted a 14-day prospective observational cohort study of 21 subjects attempting to follow either a low-carbohydrate/ketogenic or a standard diet. Subjects were asked to concurrently measure both blood BHB and BrAce five times per day and report the results using an online data entry system. We evaluated the utility of multiple daily measurements by calculating the coefficient of variation (CV) for each daily group of measurements. We calculated the correlation between coincident BrAce and blood BHB measurements using linear ordinary least squares regression analysis. We assessed the ability of the BrAce measurement to accurately predict blood BHB states using receiver operating characteristic (ROC) analysis. Finally, we calculated a daily ketone exposure (DKE) using the area under the curve (AUC) of a ketone concentration versus time graph and compared the DKE of BrAce and blood BHB using linear ordinary least squares regression.

Results

BrAce and blood BHB varied throughout the day by an average of 44% and 46%, respectively. The BrAce measurement accurately predicted whether blood BHB was greater than or less than the following thresholds: 0.3 mM (AUC = 0.898), 0.5 mM (AUC = 0.854), 1.0 mM (AUC = 0.887), and 1.5 mM (AUC = 0.935). Coincident BrAce and blood BHB measurements were moderately correlated withR2= 0.57 (P< 0.0001), similar to literature reported values. However, daily ketone exposures, or areas under the curve, for BrAce and blood BHB were highly correlated withR2= 0.83 (P< 0.0001).

Conclusions

The results validated the performance of the PBAM. The BrAce/BHB correlation was similar to literature values where BrAce was measured using highly accurate lab instruments. Additionally, BrAce measurements using the PBAM can be used to predict blood BHB states. The relatively high daily variability of ketone levels indicate that single blood or breath ketone measurements are often not sufficient to assess daily ketone exposure for most users. Finally, although single coincident blood and breath ketone measurements show only a moderate correlation, possibly due to the temporal lag between BrAce and blood BHB, daily ketone exposures for blood and breath are highly correlated.
Tracking the onset date of the community spread of SARS-CoV-2 in Western Countries
Authors: Delatorre Edson , Mir Daiana , Gräf Tiago , Bello Gonzalo
Published: April 2020

The SARS-CoV-2 rapidly spread around the world during 2020, but the precise time in which the virus began to spread locally is currently unknown for most countries. Here, we estimate the probable onset date of the community spread of SARS-CoV-2 from the cumulative number of deaths reported during the early stage of the epidemic in Western Europe and the Americas. Our results support that SARS-CoV-2 probably started to spread locally in all western countries analyzed between the middle of January and early February 2020, thus long before community transmission was officially recognized and control measures were implemented.
Measuring Icebergs: Using Different Methods to Estimate the Number of COVID-19 Cases in Portugal and Spain
Authors: Baquero Carlos , Casari Paolo , Anta Antonio Fernández , Frey Davide , Garcia-Agundez Augusto , Georgiou Chryssis , Menezes Raquel , Nicolaou Nicolas , Ojo Oluwasegun , Patras Paul
Published: April 2020

The world is suffering from a pandemic called COVID-19, caused by the SARS-CoV-2 virus. The different national governments have problems evaluating the reach of the epidemic, having limited resources and tests at their disposal. Hence, any means to evaluate the number of persons with symptoms compatible with COVID-19 with reasonable level of accuracy is useful. In this paper we present the initial results of the @CoronaSurveys project. The objective of this project is the collection and publication of data concerning the number of people that show symptoms compatible with COVID-19 in different countries using open anonymous surveys. While this data may be biased, we conjecture that it is still useful to estimate the number of infected persons with the COVID-19 virus at a given point in time in these countries, and the evolution of this number over time. We show here the initial results of the @CoronaSurveys project in Spain and Portugal.