bluuebunny/crossref_metadata_2025 huggingface dataset:
Democracy as Disorder: Institutionalized Sources of Democratic Ambivalence Among the Upper and Middle Class in Manila
Authors: Garrido Marco
Published: April 2020

Scholars contend that weak institutions as manifest in corruption and bad governance are driving people towards illiberal forms of democracy. This explanation is underspecified. It does not make clear why people are turning towards authoritarian rule instead of working to strengthen democratic institutions. It cannot explain why we are seeing, specifically, a turn to the politics of discipline in countries like the Philippines. We need a better grasp of how weak institutions are experienced and how this experience shapes people’s attitudes towards democracy. Drawing upon several years of ethnographic research, I depict the experience of democracy of the upper and middle class in Metro Manila. For informants, the problem of democracy is not that institutions are weak but that valued institutions are actively contradicted by disvalued ones. They describe an experience of disorder, identifying four major sources: corruption, rule-bending, clientelism, and informal settlement. A view of democracy as disorder prompts calls for “disciplining” it. These findings lead us to reframe the issue. Whereas a weak institutions’ framework emphasizes the gap between valued rules and regressive norms, I emphasize their contradiction as shaping perceptions of disorder. Contradiction is experienced as a moral dilemma, a conflict between how things are done and how they should be done. This experience is informed by a normative sensibility rooted in upper- and middle-class position. The framework provides a better account of democratic backsliding: socially embedded, broader in scope, and closer to experience.
Men’s Social Integration after Incarceration: The Role of Organizationally Embedded Prison-Forged Networks
Authors: Riggs Robert
Published: April 2020

Research shows that social ties and social support are central to former prisoners’ social integration; however, most scholarship focuses on family ties. Beyond family ties, we know little about the composition of former prisoners’ personal networks or how non-family ties may form and influence social integration. This article investigates in detail the personal networks of a group of male former prisoners and documents how they use their social ties during the transition into the community. In addition to family, many men were networked with others with whom they had formed relationships in prison. In contrast to criminological research on criminal peers, this study finds that networks formed through participation in prison programs operated by community-based organizations were prosocial and endured into the men’s release into the community. These organizationally embedded prison-forged networks gave transitioning men access to and impelled activation of forms of social capital in free society. These findings suggest scholars and policymakers should use care in defining what a criminal peer is and that parole policies forbidding parolees from associating with others who have criminal records may in some cases do more harm than good.
We Have Never Been Nurses
Authors: Dillard-Wright Jessica , Walsh Jane Hopkins , Brown Brandon Blaine
Published: April 2020

As nurses on this pale blue dot, the impending climate crisis requires us to engage with our world and communities differently if we hope to ensure our planetary survival, human and non. Imagining the next 50 years of nursing theory, we advance a posthuman critique of the discipline. In this article, we lay out a posthumanist critique of nursing. We urge nurses to critically engage with the realities that shape our present and future on a deteriorating planet, decentering the primacy ofhumansas we engage with the world all around and assemble posthuman tools for our analyses.
Prolonged Length of Stay and Risk of Unplanned 30-Day Readmission After Elective Spine Surgery
Authors: Kim Robert B. , Wilkerson Christopher , Karsy Michael , Joyce Evan , Rolston John D. , Couldwell William T. , Mahan Mark A.
Published: April 2020

Study Design.

Retrospective database study.

Objective.

To assess the association between prolonged length of hospital stay (pLOS) (≥4 d) and unplanned readmission in patients undergoing elective spine surgery by controlling the clinical and statistical confounders.

Summary of Background Data.

pLOS has previously been cited as a risk factor for unplanned hospital readmission. This potentially modifiable risk factor has not been distinguished as an independent risk factor in a large-scale, multi-institutional, risk-adjusted study.

Methods.

Data were collected from the American College of Surgeons National Surgical Quality Improvement Program database. A retrospective propensity score-matched analysis was used to reduce baseline differences between the cohorts. Univariate and multivariate analyses were performed to assess the degree of association between pLOS and unplanned readmission.

Results.

From the 99,575 patients that fit the inclusion criteria, propensity score matching yielded 16,920 well-matched pairs (mean standard propensity score difference = 0.017). The overall 30-day unplanned readmission rate of these 33,840 patients was 5.5%. The mean length of stay was 2.0 ± 0.9 days and 6.0 ± 4.5 days (P ≤ 0.001) for the control and pLOS groups, respectively. In our univariate analysis, pLOS was associated with postoperative complications, especially medical complications (22.7%vs.8.3%,P < 0.001). Multivariate analysis of the propensity score-matched population, which adjusted identified confounders (P < 0.02 and ≥10 occurrences), showed pLOS was associated with an increased risk of 30-day unplanned readmission (odds ratio [OR] 1.423, 95% confidence interval [CI] 1.290–1.570,P < 0.001).

Conclusion.

Patients who undergo elective spine procedures who have any-cause pLOS (≥4 d) are at greater risk of having unplanned 30-day readmission compared with patients with shorter hospital stays.

Level of Evidence:4
Effects of Rehabilitation Interventions on Clinical Outcomes in Critically Ill Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials*
Authors: Waldauf Petr , Jiroutková Kateřina , Krajčová Adéla , Puthucheary Zudin , Duška František
Published: April 2020

Objectives:

To assess the impact of rehabilitation in ICU on clinical outcomes.

Data Sources:

Secondary data analysis of randomized controlled trials published between 1998 and October 2019 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Study Selection:

We have selected trials investigating neuromuscular electrical stimulation or cycling exercises or protocolized physical rehabilitation as compared to standard of care in critically ill adults.

Data Extraction:

Mortality, length of stay in ICU and at hospital, days on mechanical ventilator, and adverse events.

Data Synthesis:

We found 43 randomized controlled trials (nine on cycling, 14 on neuromuscular electrical stimulation alone and 20 on protocolized physical rehabilitation) into which 3,548 patients were randomized and none of whom experienced an intervention-related serious adverse event. The exercise interventions had no influence on mortality (odds ratio 0.94 [0.79–1.12], n = 38 randomized controlled trials) but reduced duration of mechanical ventilation (mean difference, –1.7 d [–2.5 to –0.8 d], n = 32, length of stay in ICU (–1.2 d [–2.5 to 0.0 d], n = 32) but not at hospital (–1.6 [–4.3 to 1.2 d], n = 23). The effects on the length of mechanical ventilation and ICU stay were only significant for the protocolized physical rehabilitation subgroup and enhanced in patients with longer ICU stay and lower Acute Physiology and Chronic Health Evaluation II scores. There was no benefit of early start of the intervention. It is likely that the dose of rehabilitation delivered was much lower than dictated by the protocol in many randomized controlled trials and negative results may reflect the failure to implement the intervention.

Conclusions:

Rehabilitation interventions in critically ill patients do not influence mortality and are safe. Protocolized physical rehabilitation significantly shortens time spent on mechanical ventilation and in ICU, but this does not consistently translate into long-term functional benefit. Stable patients with lower Acute Physiology and Chronic Health Evaluation II at admission (<20) and prone to protracted ICU stay may benefit most from rehabilitation interventions.
Small molecule proteomics quantifies differences between normal and fibrotic pulmonary extracellular matrices
Authors: Wan Xin-Long , Zhou Zhi-Liang , Wang Peng , Zhou Xiao-Ming , Xie Meng-Ying , Mei Jin , Weng Jie , Xi Hai-Tao , Chen Chan , Wang Zhi-Yi , Wang Zhi-Bin
Published: April 2020

Background:

Pulmonary fibrosis is a respiratory disease caused by the proliferation of fibroblasts and accumulation of the extracellular matrix (ECM). It is known that the lung ECM is mainly composed of a three-dimensional fiber mesh filled with various high-molecular-weight proteins. However, the small-molecular-weight proteins in the lung ECM and their differences between normal and fibrotic lung ECM are largely unknown.

Methods:

Healthy adult male Sprague-Dawley rats (Rattus norvegicus) weighing about 150 to 200 g were randomly divided into three groups using random number table: A, B, and C and each group contained five rats. The rats in Group A were administered a single intragastric (i.g.) dose of 500 μL of saline as control, and those in Groups B and C were administered a single i.g. dose of paraquat (PQ) dissolved in 500 μL of saline (20 mg/kg). After 2 weeks, the lungs of rats in Group B were harvested for histological observation, preparation of de-cellularized lung scaffolds, and proteomic analysis for small-molecular-weight proteins, and similar procedures were performed on Group C and A after 4 weeks. The differentially expressed small-molecular-weight proteins (DESMPs) between different groups and the subcellular locations were analyzed.

Results:

Of the 1626 small-molecular-weight proteins identified, 1047 were quantifiable. There were 97 up-regulated and 45 down-regulated proteins in B vs. A, 274 up-regulated and 31 down-regulated proteins in C vs. A, and 237 up-regulated and 28 down-regulated proteins identified in C vs. B. Both the up-regulated and down-regulated proteins in the three comparisons were mainly distributed in single-organism processes and cellular processes within biological process, cell and organelle within cellular component, and binding within molecular function. Further, more up-regulated than down-regulated proteins were identified in most sub-cellular locations. The interactions of DESMPs identified in extracellular location in all comparisons showed that serum albumin (Alb) harbored the highest degree of node (25), followed by prolyl 4-hydroxylase beta polypeptide (12), integrin β1 (10), apolipoprotein A1 (9), and fibrinogen gamma chain (9).

Conclusions:

Numerous PQ-induced DESMPs were identified in de-cellularized lungs of rats by high throughput proteomics analysis. The DESMPs between the control and treatment groups showed diversity in molecular functions, biological processes, and pathways. In addition, the interactions of extracellular DESMPs suggested that the extracellular proteins Alb, Itgb1, Apoa1, P4hb, and Fgg in ECM could be potentially used as biomarker candidates for pulmonary fibrosis. These results provided useful information and new insights regarding pulmonary fibrosis.
The sphingosine-1-phosphate/RhoA/Rho associated kinases/myosin light chain pathway in detrusor of female rats is down-regulated in response to ovariectomy
Authors: Zhang Wei , Liu Xiao-Dong , Wang Jia-Wen , Meng Ling-Feng , Zhang Yao-Guang , Wang Jian-Ye
Published: April 2020

Background

Dysuria is one of the main symptoms of genitourinary syndrome of menopause, which causes serious disruption to the normal life of peri-menopausal women. Studies have shown that it is related to decrease of detrusor contractile function, but the exact mechanism is still poorly understood. Previous results have suggested that the sphingosine-1-phosphate (S1P) pathway can regulate detrusor contraction, and this pathway is affected by estrogen in various tissues. However, how estrogen affects this pathway in the detrusor has not been investigated. In this study, we detected changes of the S1P/RhoA/Rho associated kinases (ROCK)/myosin light chain (MLC) pathway in the detrusor of ovariectomized rats in order to explore the underlying mechanism of dysuria during peri-menopause.

Methods

Thirty-six female Sprague-Dawley rats were randomly divided into SHAM (sham operation), OVX (ovariectomy), and E groups (ovariectomy + estrogen), with 12 rats in each group. We obtained bladder detrusor tissues from each group and examined the mRNA and protein levels of the major components of the S1P/RhoA/ROCK/MLC pathway using quantitative real-time polymerase chain reaction and Western blotting, respectively. We also quantified the content of S1P in the detrusor using an enzyme linked immunosorbent assay. Finally, we compared results between the groups with one-way analysis of variance.

Results

The components of the S1P pathway and the RhoA/ROCK/MLC pathway of the OVX group were significantly decreased, as compared with SHAM group. The percent decreases of the components in the S1P pathway were as follows: sphingosine kinase 1 (mRNA: 39%, protein: 45%) (both P < 0.05), S1P (21.73 ± 1.09 nmol/g vs. 18.86 ± 0.69 nmol/g) (P < 0.05), and S1P receptor 2/3 (S1PR2/3) (mRNA: 25%, 27%, respectively) (P < 0.05). However, the protein expression levels of S1PR2/3 and the protein and mRNA levels of SphK2 and S1PR1 did not show significant differences between groups (P > 0.05). The percent decreases of the components in the RhoA/ROCK/MLC pathway were as follows: ROCK2 (protein: 41%, mRNA: 36%) (both P < 0.05), p-MYPT1 (protein: 54%) (P < 0.05), and p-MLC20 (protein: 47%) (P < 0.05), but there were no significant differences in the mRNA and protein levels of RhoA, ROCK1, MYPT1, and MLC20 (all P > 0.05). In addition, all of the above-mentioned decreases could be reversed after estrogen supplementation (E group vs. SHAM group) (all P > 0.05).

Conclusion

In this study, we confirmed that ovariectomy is closely associated with the down-regulation of the S1P/RhoA/ROCK/MLC pathway in the rat detrusor, which may be one mechanism of dysuria caused by decreased contractile function of the female detrusor during peri-menopause.
Practical use of electronic health records among patients with diabetes in scientific research
Authors: Shen Yun , Zhou Jian , Hu Gang
Published: April 2020

Electronic health (medical) records, which are also considered as patients’ information that are routinely collected, provide a great chance for researchers to develop an epidemiological understanding of disease. Electronic health records systems cannot develop without the advance of computer industries. While conducting clinical trials that are always costly, feasible and reasonable analysis of routine patients’ information is more cost-effective and reflective of clinical practice, which is also called real world study. Real world studies can be well supported by big data in healthcare industry. Real world studies become more and more focused and important with the development of evidence-based medicine. These big data will definitely help in making decisions, making policies and guidelines, monitoring of effectiveness and safety on new drugs or technologies. Extracting, cleaning, and analyzing such big data will be a great challenge for clinical researchers. Successful applications and developments of electronic health record in western countries (eg, disease registries, health insurance claims, etc) have provided a clear direction for Chinese researchers. However, it is still at primary stages in China. This review tries to provide a full perspective on how to translate the electronic health records into scientific achievements, for example, among patients with diabetes. As a summary in the end, resource sharing and collaborations are highly recommended among hospitals and healthcare groups.
Early Mobilization of Patients Receiving Vasoactive Drugs in Critical Care Units: A Systematic Review
Authors: Jacob Prasobh , Surendran Praveen Jayaprabha , E M Muhamed Aleef , Papasavvas Theodoros , Praveen Reshma , Swaminathan Narasimman , Milligan Fiona
Published: April 2020

Purpose:

Mobilization is feasible, safe, and beneficial to patients admitted to critical care units. Vasoactive therapy appears to be one of the most common barriers to early mobilization. Many recent publications have studied the safety and feasibility of mobilizing patients with these vasoactive drugs. The aim of this review was to synthesize the prevailing evidence pertaining to mobilizing patients receiving vasoactive drugs.

Methods:

The protocol was developed and registered on PROSPERO (CRD42019127448). A comprehensive literature search was conducted using PubMed, Physiotherapy Evidence Database (PEDRO), Cochrane Central, and Embase (through Cochrane) for original research, including case studies and consensus guidelines. PRISMA guidelines were used to conduct and report this review. The included articles were appraised using the Newcastle-Ottawa Scale independently and a consensus reached by 3 reviewers.

Results and Conclusion:

Evidence determining specific doses of vasoactive drugs that would allow safe mobilization of patients in critical care is lacking. The criteria that have been used to determine the eligibility to mobilize patients on vasoactive drugs have not been consistent.
Graft Selection in Anterior Cruciate Ligament Reconstruction
Authors: Lin Kenneth M. , Boyle Caroline , Marom Niv , Marx Robert G.
Published: April 2020

Surgical reconstruction of the anterior cruciate ligament (ACL) is often indicated to restore functional stability and prevent early degeneration of the knee joint, as there is little biological healing capacity of the native ACL. Although a reconstructed ACL does not fully restore the original structure or biomechanics properties of the native ACL, the graft used for reconstruction must not only have structural and mechanical properties that closely resemble those of the native ligament, it must also have minimal antigenicity and enough biological potential to incorporate into host bone. There are several considerations in graft selection: autograft versus allograft, and soft tissue grafts versus grafts with bone plugs. Commonly used grafts include bone-patella tendon-bone, hamstring, and quadriceps; among allografts, options further include tibias anterior and posterior, Achilles, an peroneal tendons. Optimal graft selection is not only dependent on graft properties, but perhaps more importantly on patient characteristics and expectations. The purpose of this review is to summarize the relevant biological, biomechancial, and clinical data regarding various graft types and to provide a basic framework for graft selection in ACL reconstruction.
Lateral Extra-articular Tenodesis in Anterior Cruciate Ligament Reconstruction
Authors: Getgood Alan , Moatshe Gilbert
Published: April 2020

A subset of patients have residual rotational laxity following anterior cruciate ligament reconstruction (ACLR) despite the evolution of ACLR techniques. In recent years, there has been increased interest in addressing residual laxity because it is associated with poor outcomes after ACLR. There is an expanding body of knowledge on the anatomy and biomechanics of the anterolateral soft tissue restraints in regard to their rotational control of the knee and this has reignited an interest in extra-articular reconstruction techniques for augmenting ACLR. Reconstruction techniques currently used can be broadly categorized as either lateral extra-articular tenodesis or anterolateral ligament reconstruction. In this review, we discuss the relevant anatomy, biomechanics, and rationale behind the indications and technique of our current extra-articular augmentation procedure.
Post-Traumatic Stress, Depression, and Quality of Life in Women with Peripartum Cardiomyopathy
Authors: Donnenwirth Jo Ann , Hess Rosanna , Ross Ratchneewan
Published: April 2020

Purpose:

Peripartum cardiomyopathy, a traumatic life-threatening type of heart failure, occurs in the last trimester of pregnancy or shortly after childbirth. Little is known about psychological or emotional conditions women experience with peripartum cardiomyopathy. The purpose of this study was to examine relationships among post-traumatic stress, depression, and quality of life in women with peripartum cardiomyopathy.

Design and Methods:

This cross-sectional, correlational survey study included 28 participants recruited via public notice on Facebook. Participants completed the Horowitz Impact of Events Scale, the Center for Epidemiology Scale–Depression 20, and the Ferrans & Powers Quality of Life Index©–Cardiac Version-IV.

Results:

Post-traumatic stress correlated significantly and positively with depression (r = .809, p < .001). Post-traumatic stress and depression correlated significantly and inversely with quality of life (r = -.455, p = .015), (r = -.544, p = .003), respectively. All participants measured positive for depression. Participants with lower education scored higher on post-traumatic stress and depression, whereas those unemployed or disabled registered a lower quality of life.

Clinical Implications:

Nurses, midwives, and physicians caring for women with cardiomyopathies must be vigilant for evidence of post-traumatic stress, depression, and poor quality of life. Targeted antenatal and postnatal support could be vital to emotional and psychological recovery.
Caring for Critically Ill Adults With Coronavirus Disease 2019 in a PICU: Recommendations by Dual Trained Intensivists*
Authors: Remy Kenneth E. , Verhoef Philip A. , Malone Jay R. , Ruppe Michael D. , Kaselitz Timothy B. , Lodeserto Frank , Hirshberg Eliotte L. , Slonim Anthony , Dezfulian Cameron
Published: April 2020

Objective:

In the midst of the severe acute respiratory syndrome coronavirus 2 pandemic, which causes coronavirus disease 2019, there is a recognized need to expand critical care services and beds beyond the traditional boundaries. There is considerable concern that widespread infection will result in a surge of critically ill patients that will overwhelm our present adult ICU capacity. In this setting, one proposal to add “surge capacity” has been the use of PICU beds and physicians to care for these critically ill adults.

Design:

Narrative review/perspective.

Setting:

Not applicable.

Patients:

Not applicable.

Interventions:

None.

Measurements and Main Results:

The virus’s high infectivity and prolonged asymptomatic shedding have resulted in an exponential growth in the number of cases in the United States within the past weeks with many (up to 6%) developing acute respiratory distress syndrome mandating critical care services. Coronavirus disease 2019 critical illness appears to be primarily occurring in adults. Although pediatric intensivists are well versed in the care of acute respiratory distress syndrome from viral pneumonia, the care of differing aged adult populations presents some unique challenges. In this statement, a team of adult and pediatric-trained critical care physicians provides guidance on common “adult” issues that may be encountered in the care of these patients and how they can best be managed in a PICU.

Conclusions:

This concise scientific statement includes references to the most recent and relevant guidelines and clinical trials that shape management decisions. The intention is to assist PICUs and intensivists in rapidly preparing for care of adult coronavirus disease 2019 patients should the need arise.
Dietary Supplements and Current Available Evidence
Authors: Xue Amy S. , Dayan Erez , Rohrich Rod J.
Published: April 2020

Dietary supplements are frequently used in surgical patients. Surgeons should be up to date with regard to the efficacies and potential complications related to these supplements. This article provides the most updated practices and evidence of commonly used supplements.
Body Mass Index and Lymphedema Morbidity: Comparison of Obese versus Normal-Weight Patients
Authors: Greene Arin K. , Zurakowski David , Goss Jeremy A.
Published: April 2020

Background:

Obesity is a risk factor for the development of secondary lymphedema after axillary lymphadenectomy and radiation therapy. The purpose of this study was to determine whether obesity influences the morbidity of lymphedema in patients who have the condition.

Methods:

Two cohorts of patients were compared: group 1, normal weight (body mass index ≤25 kg/m2); and group 2, obese (body mass index ≥30 kg/m2). Inclusion criteria were patients aged 21 years or older with lymphedema confirmed by lymphoscintigraphy. Covariates included age, sex, lymphedema type (primary or secondary), location, comorbidities, lymph node dissection, radiation therapy, lymphoscintigram result, and disease duration. Outcome variables were infection, hospitalization, and degree of limb overgrowth. The cohorts were compared using the Mann-Whitney U test, Fisher’s exact test, and multivariable logistic regression.

Results:

Sixty-seven patients were included: group 1, n = 33; and group 2, n = 34. Disease duration did not differ between groups (p = 0.72). Group 2 was more likely to have an infection (59 percent), hospitalization (47 percent), and moderate or severe overgrowth (79 percent), compared to group 1 (18, 6, and 40 percent, respectively; p < 0.001). Multivariable logistic regression showed that obesity was an independent risk factor for infection (OR, 7.9; 95 percent CI, 2.5 to 26.3; p < 0.001), hospitalization (OR, 30.0; 95 percent CI, 3.6 to 150.8; p < 0.001), and moderate to severe limb overgrowth (OR, 6.7; 95 percent CI, 2.1 to 23.0; p = 0.003).

Conclusions:

Obesity negatively affects patients with established lymphedema. Obese individuals are more likely to have infections, hospitalizations, and larger extremities compared to subjects with a normal body mass index. Patients with lymphedema should be counseled about the negative effects of obesity on their condition.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, II.
The Preimplantation Psychosocial Evaluation and Prediction of Clinical Outcomes During Mechanical Circulatory Support: What Information Is Most Prognostic?
Authors: Dew Mary Amanda , Hollenberger Jennifer C. , Obregon Laura L. , Hickey Gavin W. , Sciortino Christopher M. , Lockard Kathleen L. , Kunz Nicole M. , Mathier Michael A. , Ramani Ravi N. , Kilic Arman , McNamara Dennis M. , Simon Marc A. , Keebler Mary E. , Kormos Robert L.
Published: April 2020

Background.

Psychosocial evaluations are required for long-term mechanical circulatory support (MCS) candidates, no matter whether MCS will be destination therapy (DT) or a bridge to heart transplantation. Although guidelines specify psychosocial contraindications to MCS, there is no comprehensive examination of which psychosocial evaluation domains are most prognostic for clinical outcomes. We evaluated whether overall psychosocial risk, determined across all psychosocial domains, predicted outcomes, and which specific domains appeared responsible for any effects.

Methods.

A single-site retrospective analysis was performed for adults receiving MCS between April 2004 and December 2017. Using an established rating system, we coded psychosocial evaluations to identify patients at low, moderate, or high overall risk. We similarly determined risk within each of 10 individual psychosocial domains. Multivariable analyses evaluated whether psychosocial risk predicted clinical decisions about MCS use (DT versus bridge), and postimplantation mortality, transplantation, rehospitalization, MCS pump exchange, and standardly defined adverse medical events (AEs).

Results.

In 241 MCS recipients, greater overall psychosocial risk increased the likelihood of a DT decision (odds ratio, 1.76;P= 0.017); and postimplantation pump exchange and occurrence of AEs (hazard ratios [HRs] ≥ 1.25;P≤ 0.042). The individual AEs most strongly predicted were cardiac arrhythmias and device malfunctions (HRs ≥ 1.39;P≤ 0.032). The specific psychosocial domains predicting at least 1 study outcome were mental health problem severity, poorer medical adherence, and substance use (odds ratios and HRs ≥ 1.32;P≤ 0.010).

Conclusions.

The psychosocial evaluation predicts not only clinical decisions about MCS use (DT versus bridge) but important postimplantation outcomes. Strategies to address psychosocial risk factors before or soon after implantation may help to reduce postimplantation clinical risks.
RGS5 plays a significant role in renal cell carcinoma
Authors: Su Sumeyye , Shahriyari Leili
Published: April 2020

Recent advances in biotechnology led to generation of large complex biological and clinical datasets that can be used to infer the underlying mechanism of many diseases and arrive at personalized treatments. One of these datasets are the whole genome profiles, including a good collection of publicly available human gene expression datasets. In this project, we analysed gene expression profiles of patients with renal cell carcinoma (RCC). We found that the regulator of G-protein signalling 5 (RGS5) might play a crucial role in initiation and progression of RCC, and it might be prognostic. We observed that a high expression level of RGS5 is associated with better survival months. Importantly, when the grade of tumour increases, the RGS5 expression level significantly decreases. Although there is no difference between expression level of RGS5 in male and female patients with primary tumours in the right kidney, among patients with primary tumours in the left kidney, females have a significantly higher RGS5 expression than male patients. Interestingly, we also observed a significant association between the high expression level of RGS5 and low serum calcium level and elevated white blood cells level.
An inter-species computational analysis of vibrotactile sensitivity in Pacinian and Herbst corpuscles
Authors: Quindlen-Hotek Julia C. , Bloom Ellen T. , Johnston Olivia K. , Barocas Victor H.
Published: April 2020

Vibration sensing is ubiquitous among vertebrates, with the sensory end organ generally being a multilayered ellipsoidal structure. There is, however, a wide range of sizes and structural arrangements across species. In this work, we applied our earlier computational model of the Pacinian corpuscle to predict the sensory response of different species to various stimulus frequencies, and based on the results, we identified the optimal frequency for vibration sensing and the bandwidth over which frequencies should be most detectable. We found that although the size and layering of the corpuscles were very different, almost all of the 19 species studied showed very similar sensitivity ranges. The human and goose were the notable exceptions, with their corpuscle tuned to higher frequencies (130–170 versus 40–50 Hz). We observed no correlation between animal size and any measure of corpuscle geometry in our model. Based on the results generated by our computational model, we hypothesize that lamellar corpuscles across different species may use different sizes and structures to achieve similar frequency detection bands.
A game-theoretic approach to deciphering the dynamics of amyloid-
β
aggregation along competing pathways
Authors: Ghosh Preetam , Rana Pratip , Rangachari Vijayaraghavan , Saha Jhinuk , Steen Edward , Vaidya Ashwin
Published: April 2020

Aggregation of amyloid-
β
(A
β
) peptides is a significant event that underpins Alzheimer's disease (AD). A
β
aggregates, especially the low-molecular weight oligomers, are the primary toxic agents in AD pathogenesis. Therefore, there is increasing interest in understanding their formation and behaviour. In this paper, we use our previously established results on heterotypic interactions between A
β
and fatty acids (FAs) to investigate off-pathway aggregation under the control of FA concentrations to develop a mathematical framework that captures the mechanism. Our framework to define and simulate the competing on- and off-pathways of A
β
aggregation is based on the principles of game theory. Together with detailed simulations and biophysical experiments, our models describe the dynamics involved in the mechanisms of A
β
aggregation in the presence of FAs to adopt multiple pathways. Specifically, our reduced-order computations indicate that the emergence of off- or on-pathway aggregates are tightly controlled by a narrow set of rate constants, and one could alter such parameters to populate a particular oligomeric species. These models agree with the detailed simulations and experimental data on using FA as a heterotypic partner to modulate the temporal parameters. Predicting spatio-temporal landscape along competing pathways for a given heterotypic partner such as lipids is a first step towards simulating scenarios in which the generation of specific ‘conformer strains’ of A
β
could be predicted. This approach could be significant in deciphering the mechanisms of amyloid aggregation and strain generation, which are ubiquitously observed in many neurodegenerative diseases.
Multiple factors affect discrimination learning performance, but not between-individual variation, in wild mixed-species flocks of birds
Authors: Reichert Michael S. , Crofts Sam J. , Davidson Gabrielle L. , Firth Josh A. , Kulahci Ipek G. , Quinn John L.
Published: April 2020

Cognition arguably drives most behaviours in animals, but whether and why individuals in the wild vary consistently in their cognitive performance is scarcely known, especially under mixed-species scenarios. One reason for this is that quantifying the relative importance of individual, contextual, ecological and social factors remains a major challenge. We examined how many of these factors, and sources of bias, affected participation and performance, in an initial discrimination learning experiment and two reversal learning experiments during self-administered trials in a population of great tits and blue tits. Individuals were randomly allocated to different rewarding feeders within an array. Participation was high and only weakly affected by age and species. In the initial learning experiment, great tits learned faster than blue tits. Great tits also showed greater consistency in performance across two reversal learning experiments. Individuals assigned to the feeders on the edge of the array learned faster. More errors were made on feeders neighbouring the rewarded feeder and on feeders that had been rewarded in the previous experiment. Our estimates of learning consistency were unaffected by multiple factors, suggesting that, even though there was some influence of these factors on performance, we obtained a robust measure of discrimination learning in the wild.
A new, transitional centrosaurine ceratopsid from the Upper Cretaceous Two Medicine Formation of Montana and the evolution of the ‘
Styracosaurus
-line' dinosaurs
Authors: Wilson John P. , Ryan Michael J. , Evans David C.
Published: April 2020

Ceratopsids are among the most ubiquitous dinosaur taxa from the Late Cretaceous terrestrial formations of the Western Interior of North America, comprising two subfamilies, Chasmosaurinae and Centrosaurinae. The Two Medicine Formation of northwestern Montana has produced numerous remains of centrosaurine dinosaurs, which represent three taxa previously considered valid:
Rubeosaurus ovatus
,
Einiosaurus procurvicornis
and
Achelousaurus horneri
. Here, we reassess the previous referral of specimens to
Rubeousaurus ovatus
and demonstrate that this taxon is represented solely by its holotype specimen, which was first diagnosed as
Styracosaurus ovatus
. One of the specimens previously referred to ‘
Rubeosaurus
’
ovatus
instead represents a new eucentrosauran centrosaurine taxon diagnosed here,
Stellasaurus ancellae
gen. et sp. nov.
Stellasaurus
expresses a unique combination of eucentrosauran centrosaurine characters, including an elongate nasal horncore, diminutive supraorbital horncores, and a parietal bearing straight, elongate P3 processes, semi-elongate P4 processes and non-elongate P5, P6 and P7 processes. Within the stratigraphic succession of Eucentrosaura,
Stellasaurus
occurs intermediate to
Styracosaurus albertensis
and
Einiosaurus
, and likewise reflects intermediate morphology. Assessed within the stratigraphic, geographical, taphonomic, ontogenetic and phylogenetic framework of Unified Frames of Reference, we fail to reject the hypothesis that
Stellasaurus ancellae
represents a transitional taxon within an anagenetic lineage of eucentrosauran centrosaurines.
Evaluation of WHO listed COVID-19 qPCR primers and probe in silico with 375 SERS-CoV-2 full genome sequences
Authors: Toms Derek , Li Julang , Cai Hugh Y.
Published: April 2020

Quantitative reverse-transcription PCR (qRT-PCR) assays remains the gold standard for detection of the SARS-CoV-2 virus because of its sensitivity and specificity. However, successful design of qRT-PCR assays requires accurate viral genome sequences. With mutations accumulating as the virus is transmitted globally, we sought to compare current assays recommended by the World Health Organization with available SARS-CoV-2 genomic sequences in silico. While most sequences were conserved, there were notable mismatches, particularly in assays developed using early sequences when compared to more recent isolates. We recommend that any assay being evaluated for diagnostic tests be compared with prevalent sequence data from the region of proposed testing and that continued publicly accessible sequence information continue to be provided by the research community.
Resident physician exposure to novel coronavirus (2019-nCoV, SARS-CoV-2) within New York City during exponential phase of COVID-19 pandemic: Report of the New York City Residency Program Directors COVID-19 Research Group
Authors: Breazzano Mark P. , Shen Junchao , Abdelhakim Aliaa H. , Glass Lora R. Dagi , Horowitz Jason D. , Xie Sharon X , Moraes C. Gustavo de , Chen-Plotkin Alice , Chen Royce W. S.
Published: April 2020

Background

From March 2-April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize COVID-19 impact on NYC resident physicians.

Methods

IRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors (PDs) April 3–12, 2020, encompassing events from March 2–April 12, 2020.

Findings

From an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2,306 residents. 45.1% of programs reported at least one resident with confirmed COVID-19: 101 resident physicians were confirmed COVID-19-positive, with additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. 56.5% of programs had a resident waiting for, or unable to obtain, COVID-19 testing. Two COVID-19-positive residents were hospitalized, with one in intensive care. Among specialties with >100 residents represented, negative binomial regression indicated that infection risk differed by specialty (p=0.039). Although most programs (80%) reported quarantining a resident, with 16.8% of residents experiencing quarantine, 14.9% of COVID-19-positive residents were not quarantined. 90 programs, encompassing 99.2% of the resident physicians, reported reuse or extended mask use, and 43 programs, encompassing 60.4% of residents, felt that personal protective equipment (PPE) was suboptimal. 65 programs (74.7%) have redeployed residents elsewhere to support COVID-19 efforts.

Interpretation

Many resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty.

Funding

AHA, MPB, RWSC, CGM, LRDG, JDH are supported by NEI Core Grant P30EY019007 and an unrestricted grant from RPB. ACP and JS are supported by the Parker Family Chair. SXX is supported by the University of Pennsylvania.
Infection Density and Epidemic Size of COVID-19 in China outside the Hubei province
Authors: Liu Yukun , Qin Jing , Fan Yan , Zhou Yong , Follmann Dean A. , Huang Chiung-Yu
Published: April 2020

The novel coronavirus (COVID-19) has spread to almost all countries in the world, claiming more than 160,000 lives and sickening more than 2,400,000 people by April 21, 2020. There has been research showing that on average, each infected person spreads the infection to more than two persons. Therefore the majority of the population is at risk of infection if no intervention measures were undertaken. The true size of the COVID-19 epidemic remains unknown, as a significant proportion of infected individuals only exhibit mild symptoms or are even asymptomatic. A timely assessment of the evolving epidemic size is crucial for resource allocation and triage decisions. In this article, we modify the back-calculation algorithm to obtain a lower bound estimate of the number of COVID-19 infected persons in China outside the Hubei province. We estimate the infection density among infected and show that the drastic control measures enforced throughout China following the lockdown of Wuhan City effectively slowed down the spread of the disease in two weeks. Our findings from China are expected to provide guidelines and enlightenment for surveillance and control activities of COVID-19 in other countries around the world.
COVID-19 spreading: a recursive model
Authors: Ilyin Sergey O.
Published: April 2020

This communication describes a recursive mathematical model of the spreading COVID-19 infection, which allows estimating the effectiveness of quarantine measures. This model takes into account the contagiousness of infected people during the incubation period of the disease and the conditionally non-contagiousness of sick people due to their isolation. The model was used to analyze the situation in eight countries and to find the viral transmissibility, which made it possible to give a brief prediction of the COVID-19 spreading.
SARS-CoV-2 Detection Using an Isothermal Amplification Reaction and a Rapid, Inexpensive Protocol for Sample Inactivation and Purification
Authors: Rabe Brian A , Cepko Constance
Published: April 2020

As the current SARS-CoV-2 pandemic spreads, the need for more diagnostic capabilities is great. In order to address this need, we have developed a highly sensitive RT-LAMP assay compatible with current reagents, that utilizes a colorimetric readout in as little as 30 minutes. In addition to this, we have developed an inexpensive pipeline to further increase sensitivity without requiring highly specialized equipment. A rapid inactivation protocol capable of inactivating virions, as well as endogenous nucleases, was also developed to increase sensitivity and sample stability. This protocol, combined with our RT-LAMP assay, has a sensitivity of at least 50 viral RNA copies per microliter in a sample. To further increase the sensitivity, a purification protocol compatible with this inactivation method was developed. The inactivation and purification protocol, combined with our RT-LAMP assay, brings the sensitivity to at least 1 viral RNA copy per microliter in a sample. We hope that this inactivation and purification pipeline, which costs approximately $0.07 per sample and which uses readily available reagents, will increase the availability of SARS-CoV-2 testing, as well as expand the settings in which this testing can be performed.
A simple mathematical model for Coronavirus (COVID-19)
Authors: Melliani Said , Allaoui Abdelati El , Chadli Lalla Saadia
Published: April 2020

A novel coronavirus (COVID-19) was identified in Wuhan, China in the end of 2019, it causing an outbreak of viral pneumonia. It caused to the death rate of 4.63% among 571, 678 confirmed cases around the world to the March 28th, 2020. In this brief currentstudy, we will present a simple mathematical model where we show how the probability of successfully getting infected when coming into contact with an infected individual and the per-capita contact rate affect the healthy and infected population with time. The proposed model is used to offer predictions about the behavior of COVID-19 for a shorter period of time.
Variation in COVID-19 Outbreaks at U.S. State and County Levels
Authors: Messner Wolfgang , Payson Sarah E.
Published: April 2020

Background

The COVID-19 pandemic poses an unprecedented threat to the health and economic prosperity of the world’s population. Yet, some countries or regions within a country appear to be affected in different ways.

Objectives

This research aims to understand whether the outbreak varies significantly between U.S. states and counties.

Methods

A statistical model is estimated using publicly available outbreak data in the U.S., and regional differences are statistically analyzed.

Results

There is significant variance in outbreak data between U.S. states and counties. At the state level, the outbreak rate follows a normal distribution with an average relative growth rate of 0.197 (doubling time 3.518 days). But there is a low degree of reliability between state-wide and county-specific data reported (ICC = 0.169, p < 0.001), with a bias of 0.070 (standard deviation 0.062) as shown with a Bland-Altman plot.

Conclusions

The results emphasize the need for policy makers to look at the pandemic from the smallest population subdivision possible, so that countermeasures can be implemented, and critical resources provided effectively. Further research is needed to understand the reasons for these regional differences.
Performance of temporal artery temperature measurement in ruling out fever: implications for COVID-19 screening
Authors: Haimovich Adrian D. , Taylor R. Andrew , Krumholz Harlan M. , Venkatesh Arjun K.
Published: April 2020

The use of non-invasive temperature testing methods like temporal artery thermometers (TATs) is growing exponentially in the face of the ongoing COVID-19 pandemic. We performed a retrospective analysis of over 1.8 million emergency department electronic health records to identify assess the performance of TAT measurement using patients with near-contemporaneous temperature measurements taken via rectal or oral approaches. Using over 17,000 matched measurements, we show poor fever sensitivity using TAT. We show that sensitivity is significantly improved by lowering the fever threshold and describe limits of agreement between methods of measurement. Our findings suggest that private, public, and healthcare delivery organizations may need to reconsider how we perform high-volume screening during this time of crisis and has implications for return-to-work protocols.