bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive Disorders in HIV/AIDS: A Clinically Focused Narrative Review
Authors: Medeiros Gustavo C. , Smith Felicia A. , Trivedi Madhukar H. , Beach Scott R.
Published: April 2020

Learning objectives

After participating in this activity, learners should be better able to:

• Assess strategies for diagnosing depressive disorders in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)

• Identify factors that contribute to the development of depressive disorders in HIV/AIDS

• Evaluate strategies for managing depressive disorders in HIV/AIDS

Depressive disorders and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are associated with major socioeconomic burdens. The negative impact of depressive disorders on HIV/AIDS is well known, including on treatment outcomes. Unfortunately, depressive disorders are underdiagnosed and undertreated in seropositive persons. This review summarizes clinically useful information on depressive disorders in HIV/AIDS. More specifically, we address assessment, differential diagnosis, contributing factors, management, and common challenges in the treatment of depressive disorders in seropositive individuals. Assessment and diagnosis of depression may be challenging in seropositive persons because of several biopsychosocial particularities associated with HIV/AIDS. One of the difficulties is the overlap between depression and HIV/AIDS symptoms, particularly in individuals with advanced AIDS, requiring consideration of a broad differential diagnosis. Several factors related to HIV/AIDS status contribute to the higher rates of depressive disorders, including infectious-immunological, psychosocial, and exogenous factors. The treatment of depressive disorders in HIV/AIDS involves three groups of interventions: (1) pharmacological interventions, (2) psychotherapeutic interventions, and (3) management of other contributing factors. Challenges in management include poor adherence to treatment and the risk of suicide. We provide evidence-based recommendations to improve assessment and management of depressive disorders in seropositive persons.
CLINICAL FEATURES OF FLAT IRREGULAR PIGMENT EPITHELIAL DETACHMENT ASSOCIATED WITH CHOROIDAL NEOVASCULARIZATION IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Guo Jingli , Tang Wenyi , Liu Wei , Chang Qing , Xu Gezhi
Published: April 2020

Purpose:

To describe the multimodal imaging characteristics of flat irregular pigment epithelial detachment (FIPED) in patients with chronic central serous chorioretinopathy and determine the risk factors for vascularized FIPED and to explore the activity of vascularized FIPED before and after half-dose photodynamic therapy.

Methods:

Multimodal imaging data of 185 eyes of 155 consecutive patients with chronic central serous chorioretinopathy included spectral domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography. Optical coherence tomography angiography was available for 56 eyes. Flat irregular PED was classified into two types based on indocyanine green angiography or optical coherence tomography angiography findings: avascular FIPED and vascularized FIPED.

Results:

The avascular FIPED and vascularized FIPED were detected in 127 (68.6%) and 42 (22.7%) eyes, respectively. Age (P = 0.001), visual acuity (P = 0.048), subfoveal choroidal thickness (P = 0.032), height (P < 0.001) and width (P < 0.001) of FIPED, choriocapillary thickness (P = 0.015), and maximum vessel diameter (P = 0.009) beneath the FIPED were significantly different between avascular and vascularized FIPEDs. Old age was an independent risk factor for vascularized FIPED. On optical coherence tomography angiography, all vascularized FIPEDs manifested the pattern of mature choroidal neovascularization (CNV). After half-dose photodynamic therapy, vascularized FIPED remained stable without the reaccumulation of subretinal fluid at the last follow-up.

Conclusion:

In chronic central serous chorioretinopathy, vascularized FIPED was closely associated with Type I CNV. Old age was an independent risk factor for vascularized FIPED. Vascularized FIPED is suggested as “quiescent” CNV, and half-dose photodynamic therapy may be recommended as the first-line therapy in chronic central serous chorioretinopathy complicated with quiescent CNV, except when the activity of CNV becomes evident.
ASSESSING THE ABILITY OF PREOPERATIVE QUANTITATIVE SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY CHARACTERISTICS TO PREDICT VISUAL OUTCOME IN IDIOPATHIC MACULAR HOLE SURGERY
Authors: Mehta Nitish , Lavinsky Fabio , Larochelle Ryan , Rebhun Carl , Mehta Nihaal B. , Yanovsky Rebecca L. , Cohen Michael N. , Lee Gregory D. , Dedania Vaidehi , Ishikawa Hiroshi , Wollstein Gadi , Schuman Joel S. , Waheed Nadia , Modi Yasha
Published: April 2020

Purpose:

To determine which spectral domain optical coherence tomography biomarkers of idiopathic macular hole (MH) correlate with the postoperative best-corrected visual acuity (BCVA) in anatomically closed MH.

Methods:

Retrospective analysis of spectral domain optical coherence tomography scans of 44 patients presenting with MH followed for a mean of 17 months. Widths of MH aperture, base, and ellipsoid zone disruption were calculated from presenting foveal spectral domain optical coherence tomography B-scans. Macular hole base area and ellipsoid zone disruption area were calculated through the custom in-house software.

Results:

Poorer postoperative BCVA correlated with increased preoperative choroidal hypertransmission (r = 0.503, P = 0.0005), minimum diameter (r = 0.491, P = 0.0007), and base diameter (r = 0.319, P = 0.0348), but not with preoperative ellipsoid zone width (r = 0.199, P = 0.2001). Applying en-face analysis, the BCVA correlated weakly with preoperative ellipsoid zone loss area (r = 0.380, P = 0.013), but not with preoperative MH base area (r = 0.253, P = 0.1058).

Conclusion:

Increased MH minimum diameter, base diameter, base area, and choroidal hypertransmission are correlated with a poorer postoperative BCVA. Ellipsoid zone loss measurements were not consistently correlated with a BCVA. Choroidal hypertransmission width may be an easy-to-visualize predictive imaging biomarker in MH surgery.
Ocular Clinical Signs and Diagnostic Tests Most Compatible With Keratoconjunctivitis Sicca: A Latent Class Approach
Authors: Gonzales John A. , Shiboski Stephen C. , Bunya Vatinee Y. , Akpek Esen K. , Rose-Nussbaumer Jennifer , Seitzman Gerami D. , Criswell Lindsey A. , Shiboski Caroline H. , Lietman Thomas M.
Published: April 2020

Purpose:

To evaluate the ocular signs and tests for keratoconjunctivitis sicca (KCS) in the absence of a gold standard.

Methods:

Cross-sectional study of participants from the Sjögren's International Collaborative Clinical Alliance (SICCA) registry. Participants had oral/ocular/rheumatologic examinations, blood/saliva samples collected, and salivary gland biopsy. Latent class analysis (LCA) identified clusters of patients based on 3 to 4 predictor variables relating to signs or tests of KCS. The resulting model-based “gold standard” classification formed the basis for estimated sensitivity and specificity associated with these predictors.

Results:

A total of 3514 participants were enrolled into SICCA, with 52.9% classified as SS. LCA revealed a best-fit model with 2 groups. For the gold standard–positive group, an abnormal tear breakup time, ocular staining score (OSS), and Schirmer I had a sensitivity of 99.5%, 91.0%, and 47.4%, respectively. For the gold standard–negative group, an abnormal tear breakup time, OSS, and Schirmer I had a specificity of 32.0%, 84.0%, and 88.5%, respectively. OSS components (fluorescein and lissamine staining), exhibited a sensitivity of 82.6% and 90.5%, respectively, in the gold standard–positive group, whereas these signs in the gold standard–negative group had a specificity of 88.8% and 73.0%, respectively.

Conclusions:

OSS and its components (fluorescein and lissamine staining) differentiated 2 groups from each other better than other KCS parameters and had relatively high sensitivity and specificity.
Rehabilitation of Alien Hand Syndrome Complicated by Contralateral Limb Apraxia
Authors: Alvarez Armando , Weaver Martin , Alvarez Gemayaret
Published: April 2020

A previously independent 66-yr-old right-handed man presented with right-sided weakness, preferring the lower limbs with additional impaired gait and dysarthria for 1-day duration. Imaging found a large left hemispheric anterior cerebral artery ischemic infarction with multiple lacunar infarcts. He exhibited frontal, callosal, and posterior variants of alien hand syndrome, which impeded activities of daily living. Though limited in evidence, a trial of clonazepam was initiated based on previous case reports describing suspected efficacy. Botulinum toxin A was not used given the patient’s immediate need and limited hospital length of stay. Right upper limb constricting therapies improved intermanual conflict and spontaneous grasping and levitation (arm elevation in retroflexion) activity; however, concomitant left upper limb motor apraxia complicated task-oriented activities. The combination of pharmaceutical and therapeutic interventions improved the patient’s quality of life as assessed by clinical observation, functional independence measures from 41 to 57, and patient reporting. This case report aims to increase awareness of a potential barrier to rehabilitation of a debilitating and rare condition and to discuss current assessment tools and treatment options supported by available evidence.
Segmental Bioelectrical Impedance Analysis of the Body Composition of Affected and Unaffected Limbs After Hemiparetic Stroke
Authors: Kim So Jung , Yu Eun-Ho , Min Ji Hong , Shin Yong-Il , Ko Hyun-Yoon , Ko Sung-Hwa
Published: April 2020

Objective

The aim of the study was to analyze differences in body composition between affected and unaffected limbs using segmental bioelectrical impedance analysis in hemiparetic stroke patients.

Design

The segmental bioelectrical impedance analysis results and body composition of 213 hospitalized hemiparetic stroke patients were retrospectively reviewed. Subjects were divided into acute, subacute, and chronic groups according to the period after the onset of stroke. Segmental lean mass and segmental body water values were compared between affected and unaffected upper and lower limbs in all subjects and in subgroups. The mean differences of body compositions between the affected and unaffected limbs between the three groups were also compared.

Results

No significant differences in segmental lean mass and segmental body water values were observed between the affected and unaffected upper and lower limbs in total and in three subgroups. The mean differences in segmental lean mass and segmental body water values between the affected and unaffected upper limbs in the chronic group were larger than those in the acute and subacute groups.

Conclusions

There were no significant differences in body composition between affected and unaffected limbs in patients with hemiparetic stroke. The differences in body composition in the affected and unaffected upper limbs in chronic stroke patients were larger than those in acute and subacute stroke patients. Further longitudinal studies are needed.
High FDG Uptake in Pleomorphic Hyalinizing Angiectatic Tumor
Authors: Yamamoto Asako , Kikuchi Yoshinao , Abe Satoshi , Ishida Tsuyoshi , Kaminaga Tatsuro
Published: April 2020

PHAT (pleomorphic hyalinizing angiectatic tumor) is a rare, locally aggressive, low-grade mesenchymal neoplasm of uncertain lineage with a predilection for the lower extremities. We report a 74-year-old woman with an enlarging mass on the right popliteal fossa undergoing FDG PET/CT to characterize its biological activity. Increased accumulation of FDG (SUVmax, 23.0) in the solid component of the tumor was seen. Diagnosis of PHAT was confirmed by examination of the surgical resection specimens. This case showed significant FDG accumulation relative to its pathological low-grade malignant nature.
Is Sleep Quality Impaired and Is There Increased Risk of Obstructive Sleep Apnea Syndrome in Patients With Compensated Liver Cirrhosis?
Authors: Bueno Camila Guarnieri Ribeiro , Andrechuk Carla Renata Silva , Ceolim Maria Filomena
Published: April 2020

As liver cirrhosis worsens, sleep pattern impairment and related complaints increase. The objective of this study was to identify the prevalence of poor sleep, excessive daytime sleepiness, and increased risk for obstructive sleep apnea syndrome in adults with Child–Pugh Class A liver cirrhosis; to investigate the association between poor sleep quality, daytime sleepiness, and risk for obstructive sleep apnea syndrome; and to verify the relationship between these 3 variables and clinical, laboratory, and sociodemographic data. A cross-sectional study was conducted with 100 individuals at the outpatient clinic of a university hospital in the interior of Sao Paulo, Brazil. Questionnaires were used in the form of interviews and consultation of medical records. There was a prevalence of 35.0% of poor sleep quality, 29.0% of excessive daytime sleepiness, and 38.0% of high risk for obstructive sleep apnea syndrome, as well as a significant association between high risk for obstructive sleep apnea syndrome and poor sleep quality. There was no significant association between laboratory variables and sleep quality, daytime sleepiness, and high risk for obstructive sleep apnea syndrome. There is a high prevalence of poor sleep, excessive sleepiness, and high risk for obstructive sleep apnea syndrome, and poor sleep quality is related to a high risk for obstructive sleep apnea syndrome among patients with compensated liver cirrhosis.
Experiences With Traditional Chinese Medicine Among Patients With Inflammatory Bowel Disease
Authors: Cai Qian , Wu Linye , Zhou Yunxian
Published: April 2020

Despite the increasing number of inflammatory bowel disease (IBD) patients using traditional Chinese medicine (TCM), relatively few studies have examined their experiences with TCM in the Chinese healthcare context. The aim of this study was to explore these experiences from the perspective of IBD patients. Adopting a qualitative descriptive method, IBD patients from several comprehensive hospitals in Hangzhou, Zhejiang were recruited through purposive sampling. Data were collected using semistructured interviews and analyzed by a conventional content analysis method. The results are presented thematically. Fourteen IBD patients participated in the study. They often used TCM, such as Chinese herbal medicine, retention enemas of Chinese medicine, and acupuncture, as a complementary therapy instead of as an alternative to conventional therapies. Three themes emerged from the analysis: triggers for initiating TCM, the experienced efficacies of TCM, and disturbances caused by TCM use. The IBD patients initiate TCM treatment due to the unsatisfactory effects of conventional therapies and TCM culture. However, the efficacies of TCM are subjective and slow acting and vary across individuals. There are communication gaps between physicians and patients concerning TCM. Thus, healthcare professionals are encouraged to gain more knowledge on these therapies and employ a participatory decision-making style based on this understanding.
Treatment of blunt cerebrovascular injuries: Anticoagulants or antiplatelet agents?
Authors: Hanna Kamil , Douglas Molly , Asmar Samer , Khurrum Muhammad , Bible Letitia , Castanon Lourdes , Ditillo Michael , Kulvatunyou Narong , Joseph Bellal
Published: April 2020

BACKGROUND

Blunt cerebrovascular injury (BCVI) is associated with cerebrovascular accidents (CVA). Early therapy with antiplatelet agents or anticoagulants is recommended. There are limited data comparing the effectiveness of these treatments. The aim of our study was to compare outcomes between BCVI patients who received anticoagulants versus those who received antiplatelet agents.

METHODS

We performed an (2011–2015) analysis of the Nationwide Readmission Database and included all adult trauma patients 18 years or older who had an isolated BCVI (other body regions Abbreviated Injury Scale [AIS] < 3). Head injury patients or those who developed a CVA during the index admission were excluded. Patients were stratified into anticoagulants and antiplatelet agents. Propensity score matching was performed (1:1 ratio) to control for demographics, comorbidities, BCVI grade, distribution, and severity of injuries. Outcomes were readmission with CVA and mortality within 6 months.

RESULTS

A total of 725 BCVI patients were identified. A matched cohort of 370 patients (antiplatelet agents, 185; anticoagulants, 185) was obtained. Mean age was 50 ± 15 years, neck AIS was 3 (3,4), and Injury Severity Score was 12 (9–17). The majority of the patients (69%) had high-grade BCVI (AIS ≥ 3). Overall, 3.7% were readmitted with CVA and 3% died within 6 months. Patients who received anticoagulants had a lower rate of readmission with CVA (1.8% vs. 5.72%; p = 0.03), and a lower rate of 6-month mortality (1.3% vs. 4.9%; p = 0.03). There was no significant difference between the two groups reading the median time to stroke (9 days vs. 6 days; p = 0.12).

CONCLUSION

The BCVI patients on CVA prophylaxis for BCVI have a 3.7% rate of stroke after discharge. Compared with antiplatelet agents, anticoagulants are associated with lower rates of CVA in the first 6-month postdischarge. Further studies are required to identify the optimal agent to prevent CVA in this high-risk subset of trauma patients.

LEVEL OF EVIDENCE

Therapeutic, level IV.
Persistent inflammatory states and their implications in brain disease
Authors: Valdés-Ferrer Sergio I. , Benkendorff Alexander , Sankowski Roman
Published: April 2020

Purpose of review

Apart from mental, motor and sensory functions, the human central nervous system (CNS) regulates a plethora of homeostatic (autonomic and hormonal) bodily functions. These functions are dependent on specialized neuronal networks. To ensure connectivity of these networks, they are continuously refined and supported by glial cells that outnumber neurons by, according to some accounts, an order of magnitude. Among glial cells, microglia – the brain resident macrophages – plays a crucial role in maintaining neuronal networks. However, in their concomitant role as brain immune cells microglia also engage in inflammatory signaling that may disrupt neuronal networks. Here, we review novel insights for molecular pathways involved in the protective functions of microglia and other immune cells in response to systemic signals and stimuli.

Recent findings

Recent evidence suggests that aging and systemic disease push individual microglia toward proinflammatory phenotypes compromising the connectivity of neuronal networks, resulting in neuropsychiatric disease. Furthermore, cells (self as well as the microbiome) outside the CNS have been shown to affect neuronal function.

These recent findings have critical implications for mental health, particularly of an aging population, in particular for the development of novel immunomodulatory therapies for brain disease.
Cultivation and description of Duncaniella dubosii sp. nov., Duncaniella freteri sp. nov. and emended description of the species Duncaniella muris
Authors: Miyake Sou , Ding Yichen , Soh Melissa , Low Adrian , Seedorf Henning
Published: April 2020

Three bacterial strains, C9, H5 and TLL-A3, were isolated from fecal pellets of conventionally raised C57BL/6J mice. Analysis of 16S rRNA genes indicated that the strains belonged to the

Muribaculaceae

, and shared 91.6–99.9 % sequence identity with the recently described

Duncaniella muris

DSM 103720T. Genome-sequencing of the isolates was performed to compare average nucleotide identities (ANI) between strains. The ANI analysis revealed that all isolates shared highest ANI with

D. muris

DSM 103720T, with strain C9 being most similar (ANI: 98.0 %) followed by strains H5 (ANI: 76.4 %) and TLL-A3 (ANI: 74.4 %). Likewise, digital DNA–DNA hybridization (dDDH) indicated high similarity of strain C9 (dDDH: 86.6 %) to

D. muris

DSM 103720T, but strains H5 and TLL-A3 showed lower similarity (dDDH <35 %) to either of the three type species of the

Muribaculaceae

(

Muribaculum intestinale

DSM 28989T
, Paramuribaculum intestinale DSM 100749T,

D. muris

DSM 103720T). MK-10 and MK-11 were abundant in all three isolates, but concentrations varied between species. Based on genotypic, phylogenetic and phenotypic differences, the strains TLL-A3 and H5 are considered to represent novel species of the genus

Duncaniella

, for which the names Duncaniella freteri sp. nov., and Duncaniella dubosii sp. nov., are proposed. The respective type strains are TLL-A3T (=DSM 108168T=KCTC 15769T), and H5T (=DSM 107170T=KCTC 15734T). Strain C9 reveals limited sequence dissimilarity and minor differences in morphological properties with

Duncaniella muris

DSM 103720T and is therefore proposed to belong to the same species. The respective strain is C9 (=DSM 107165=KCTC 15733).
Automatic X-ray COVID-19 Lung Image Classification System based on Multi-Level Thresholding and Support Vector Machine
Authors: Mahdy Lamia Nabil , Ezzat Kadry Ali , Elmousalami Haytham H. , Ella Hassan Aboul , Hassanien Aboul Ella
Published: April 2020

The early detection of SARS-CoV-2, the causative agent of (COVID-19) is now a critical task for the clinical practitioners. The COVID-19 spread is announced as pandemic outbreak between people worldwide by WHO since 11/ March/ 2020. In this consequence, it is top critical priority to become aware of the infected people so that prevention procedures can be processed to minimize the COVID-19 spread and to begin early medical health care of those infected persons. In this paper, the deep studying based totally methodology is usually recommended for the detection of COVID-19 infected patients using X-ray images. The help vector gadget classifies the corona affected X-ray images from others through usage of the deep features. The technique is useful for the clinical practitioners for early detection of COVID-19 infected patients. The suggested system of multi-level thresholding plus SVM presented high accuracy in classification of the infected lung with Covid-19. All images were of the same size and stored in JPEG format with 512 * 512 pixels. The average sensitivity, specificity, and accuracy of the lung classification using the proposed model results were 95.76%, 99.7%, and 97.48%, respectively.
COVID-19 and maternal mental health: Are we getting the balance right?
Authors: Topalidou Anastasia , Thomson Gill , Downe Soo
Published: April 2020

This paper presents a rapid evidence review into the clinical and psychological impacts of COVID-19 on perinatal women and their infants. Literature search revealed that there is very little formal evidence on the impact of COVID-19 on pregnant, labouring and postnatal women or their babies. The clinical evidence to date suggests that pregnant and childbearing women, and their babies are not at increased risk of either getting infected, or of having severe symptoms or consequences than the population as a whole. There is no evidence on the short- and longer-term psychological impacts of restrictive practices or social and personal constraints for childbearing women during COVID-19 in particular, or infection pandemics in general. The potential for adverse mental health consequences of the pandemic should be recognised as a critical public health concern, together with appropriate care and support to prevent and ameliorate any negative impacts.
Differential COVID-19-attributable mortality and BCG vaccine use in countries
Authors: Shet Anita , Ray Debashree , Malavige Neelika , Santosham Mathuram , Bar-Zeev Naor
Published: April 2020

While mortality attributable to COVID-19 has devastated global health systems and economies, striking regional differences have been observed. The Bacille Calmette Guérin (BCG) vaccine has previously been shown to have non-specific protective effects on infections, as well as long-term efficacy against tuberculosis. Using publicly available data we built a simple log-linear regression model to assess the association of BCG use and COVID-19-attributable mortality per 1 million population after adjusting for confounders including country economic status (GDP per capita), and proportion of elderly among the population. The timing of country entry into the pandemic epidemiological trajectory was aligned by plotting time since the 100th reported case. Countries with economies classified as lower-middle-income, upper-middle-income and high-income countries (LMIC, UMIC, HIC) had median crude COVID-19 log-mortality of 0.4 (Interquartile Range (IQR) 0.1, 0.4), 0.7 (IQR 0.2, 2.2) and 5.5 (IQR 1.6, 13.9), respectively. COVID-19-attributable mortality among BCG-using countries was 5.8 times lower [95% CI 1.8-19.0] than in non BCG-using countries. Notwithstanding limitations due to testing constraints in LMICs, case ascertainment bias and a plausible rise of cases as countries progress along the epidemiological trajectory, these analyses provide intriguing observations that urgently warrant mobilization of resources for prospective randomized interventional studies and institution of systematic disease surveillance, particularly in LMICs.
Increased cortical excitability and reduced brain response propagation during attentional lapses
Authors: Cardone Paolo , Van Egroo Maxime , Chylinski Daphne , Narbutas Justinas , Gaggioni Giulia , Vandewalle Gilles
Published: April 2020

Modern lifestyle curtails sleep and increases nighttime work and leisure activities. This has a deleterious impact on vigilance and attention, exacerbating chances of committing attentional lapses, with potential dramatic outcomes. A full characterization of the brain mechanisms associated with lapses is still lacking. Here, we investigated the brain signature of attentional lapses and assessed whether cortical excitability and brain response propagation were modified during lapses and whether these modifications changed with aging. We compared electroencephalogram (EEG) responses to transcranial magnetic stimulation (TMS) during lapse and no-lapse periods while performing a continuous attentional/vigilance task at night, after usual bedtime. Data were collected in healthy younger (N=12; 18-30 y) and older individuals (N=12; 50-70 y) of both sexes. Amplitude and slope of the first component of the TMS-Evoked Potential (TEP) and Response Scattering (ReSc) were used to assess cortical excitability and brain response propagation, respectively. In line with our predictions, TEP during lapses was characterized by larger amplitude and slope. We further found that ReSc over the cortical surface was lower during lapses. Importantly, cortical excitability increase and response propagation decrease during lapse did not significantly differ between age groups. These results demonstrate that attentional lapses are associated with transient increase of excitability, and decrease in response propagation and effective connectivity. This pattern is similar to what is observed during sleep, suggesting that lapses reflect a sleep-like phenomenon. These findings could contribute to develop models aimed to predicting and preventing lapses in real life situations.

Highlights

Cortical excitability increases during attentional lapses

Brain response propagation is reduced during attentional lapses

Aging does not affect the differences between normal attention and lapse periods

Lapses characteristics resemble previous reports made during sleep
Impact of time and temperature on gut microbiota and SCFA composition in stool samples
Authors: Cunningham Janet L. , Bramstång Ludvig , Singh Abhijeet , Jayarathna Shishanthi , Rasmusson Annica J. , Moazzami Ali , Müller Bettina
Published: April 2020

Gut dysbiosis has been implicated in the pathophysiology of a growing number of non-communicable diseases. High through-put sequencing technologies and short chain fatty acid (SCFA) profiling enables surveying of the composition and function of the gut microbiota and provide key insights into host-microbiome interactions. However, a methodological problem with analyzing stool samples is that samples are treated and stored differently prior to submission for analysis potentially influencing the composition of the microbiota and its metabolites. In the present study, we simulated the sample acquisition of a large-scale study, in which stool samples were stored for up to two days in the fridge or at room temperature before being handed over to the hospital. To assess the influence of time and temperature on the microbial community and on SCFA composition in a controlled experimental setting, the stool samples of 10 individuals were exposed to room and fridge temperatures for 24 and 48 hours, respectively, and analyzed using 16S rRNA gene amplicon sequencing, qPCR and nuclear magnetic resonance spectroscopy. To best of our knowledge, this is the first study to investigate the influence of storage time and temperature on the absolute abundance of methanogens, and ofLactobacillus reuteri. The results indicate that values obtained for methanogens,L. reuteriand total bacteria are still representative even after storage for up to 48 hours at RT (20°C) or 4°C. The overall microbial composition and structure appeared to be influenced more by laboratory errors introduced during sample processing than by the actual effects of temperature and time. Although microbial activity was demonstrated by elevated SCFA at both 4 °C and RT, SCFAs ratios were more stable over the different conditions and may be considered as long as samples are come from similar storage conditions.
Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study
Authors: Doherty Mary , Neilson Stuart D , O'Sullivan Jane D , Carravallah Laura , Johnson Mona , Cullen Walter , Gallagher Louise
Published: April 2020

Background

Autistic people experience significantly poorer physical and mental health along with reduced life expectancy.

Aim

To identify self-reported barriers to primary care by autistic adults compared to parents of autistic children and non-autistic adults and link these barriers to self-reported adverse health consequences.

Design and Setting

Following consultation with the autistic community at an autistic conference, Autscape, a quantitative and qualitative survey was developed.

Method

The self-report survey was administered online through social media platforms.

Results

The 57-item online survey was completed by 507 autistic adults, 196 parents of autistic children and 157 control subjects. 79.7% of autistic adults, 52.8% of parents and 36.5% of controls reported difficulty visiting a GP. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72.2%), difficulty making appointments by telephone (61.9%), not feeling understood (55.8%), difficulty communicating with their doctor (53.1%) and the waiting room environment (50.5%).

Autistic adults reported a preference for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait.

Increased adverse health outcomes reported by autistic adults correlated with difficulty attending, including untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions.

Conclusion

Reduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives and communication needs. Adjustments for autism specific needs are as necessary as ramps for wheelchair users.

How this fits in

Adverse health outcomes are common among autistic people and so it is important to understand how we can promote access to primary care.

This cross sectional study indicates that 79.7% of autistic patients (compared to 36.5% of controls) reported difficulty visiting a GP.

Common barriers were: deciding if symptoms warrant a GP visit, difficulty using the telephone to book appointments, not feeling understood and difficulty communicating with their doctor.

Common suggestions to promote access included: online or text based appointment booking facility, emailing in advance the reason for consultation, providing first or last clinic appointment and having a quiet place to wait.
Distribution of residual disease in the peritoneum following neoadjuvant chemotherapy in advanced epithelial ovarian cancer and its potential therapeutic implications
Authors: Bhatt Aditi , Bakrin Naoual , Kammar Praveen , Mehta Sanket , Sinukumar Snita , Parikh Loma , Shaikh Sakina , Mishra Suniti , Shah Mita Y , Kepenkian Vahan , Benzerdjeb Nazim , Glehen Olivier
Published: April 2020

Introduction

Residual disease in ‘normal appearing’ peritoneum is seen in nearly 30% following neoadjuvant chemotherapy for advanced epithelial ovarian cancer. Our goal was to study prospectively, the sequence of response in different regions, the commonest sites of occult residual disease, its incidence in different peritoneal regions and the potential therapeutic implications of these.

Methods

The patterns of response were studied based on the finding of residual disease in cytoreductive surgery specimens on pathological evaluation. A protocol for pathological evaluation was laid down and followed. Informed consent was taken from all patients. A correlation between clinical and pathological findings was made. Sugarbaker’s peritoneal cancer index was used to describe the regional distribution of peritoneal disease

Results

In 85 patients treated between July 2018 to June 2019, 83 FIGO stage III-C at diagnosis and 2 stage IV-A. Microscopic disease in ‘normal appearing’ peritoneal regions was seen in 22 (25.2%) and in normal peritoneum around tumor nodules in 30 (35.2%). Regions 4 and 8 of Sugarbaker’s peritoneal cancer index had the highest incidence of residual disease in absence of visible disease and regions 9 and 10 the lowest. The response to chemotherapy occurred in a similar manner in over 95% of the patients-the least common site of residual disease was the small bowel mesentery, followed by upper regions (regions 1-3), omentum and middle regions (regions 0, 4, 8), lower regions (regions 5-7) and lastly the ovaries. Nearly 85% had 4 or more peritonectomies and 67% had 6-7 peritonecomies.

Conclusions

Complete resection of involved the peritoneal region could address all the occult disease in a particular region. The role of resection of the entire region as well as ‘normal appearing’ parietal peritoneal regions (or total parietal peritonectomy) during interval cytoreduction should be prospectively evaluated to determine its impact on morbidity and survival.
Exponential phase of covid19 expansion is driven by airport connections
Authors: Coelho Marco Túlio Pacheco , Rodrigues João Fabricio Mota , Medina Anderson Matos , Scalco Paulo , Terribile Levi Carina , Vilela Bruno , Diniz-Filho José Alexandre Felizola , Dobrovolski Ricardo
Published: April 2020

The pandemic state of COVID-19 caused by the SARS CoV-2 put the world in quarantine, led to hundreds of thousands of deaths and is causing an unprecedented economic crisis. However, COVID-19 is spreading in different rates at different countries. Here, we tested the effect of three classes of predictors, i.e., socioeconomic, climatic and transport, on the rate of daily increase of COVID-19. We found that global connections, represented by countries’ importance in the global air transportation network, is the main explanation for the growth rate of COVID-19 in different countries. Climate, geographic distance and socioeconomics had a milder effect in this big picture analysis. Geographic distance and climate were significant barriers in the past but were surpassed by the human engine that allowed us to colonize most of our planet land surface. Our results indicate that the current claims that the growth rate of COVID-19 may be lower in warmer and humid tropical countries should be taken very carefully, at risk to disturb well-established and effective policy of social isolation that may help to avoid higher mortality rates due to the collapse of national health systems.
Estimation of the probability of reinfection with COVID-19 coronavirus by the SEIRUS model
Authors: Okhuese Victor Alexander
Published: April 2020

With sensitivity of the Polymerase Chain Reaction (PCR) test used to detect the presence of the virus in the human host, the global health community has been able to record a great number of recovered population. Therefore, in a bid to answer a burning question of reinfection in the recovered class, the model equations which exhibits the disease-free equilibrium (E0) state for COVID-19 coronavirus was developed in this study and was discovered to both exist as well as satisfy the criteria for a locally or globally asymptotic stability with a basic reproductive number R0 = 0 for and endemic situation. Hence, there is a chance of no secondary reinfections from the recovered population as the rate of incidence of the recovered population vanishes, that is, B = 0.

Furthermore, numerical simulations were carried to complement the analytical results in investigating the effect of the implementation of quarantine and observatory procedures has on the projection of the further spread of the virus globally. Result shows that the proportion of infected population in the absence of curative vaccination will continue to grow globally meanwhile the recovery rate will continue slowly which therefore means that the ratio of infection to recovery rate will determine the death rate that is recorded globally and most significant for this study is the rate of reinfection by the recovered population which will decline to zero over time as the virus is cleared clinically from the system of the recovered class.
Global epidemiology, pathogenesis, immune response, diagnosis, treatment, economic and psychological impact, challenges, and future prevention of COVID-19: A Scoping review
Authors: Berhe Brhane , Legese Haftom , Degefa Hagos , Adhanom Gebre , Gebrewahd Aderajew , Mardu Fitsum , Tesfay Kebede , Welay Miglas , Negash Hadush
Published: April 2020

Background

Globally, the novel coronavirus, is a public health problem causing respiratory infections. Since the outbreak of severe acute and Middle East respiratory syndromes coronavirus was not reported to cause human infections. Now, it become an epidemic proportion with growing number of cases and deaths.

Methods

A scoping review was conducted following the methodological framework. In this scoping review, 50 records published before 28 March, 2020 were included and discussed to better understand the current epidemiology, pathogenesis, immunological response, diagnosis, evasion mechanisms and suggested strategies to boost immune system, challenges, treatment, and future preventions of the virus. PubMed, BioRxiv, MedRxiv, Global Health and google scholars were searched comprehensively for articles, preprints, grey literatures, reports, websites, conference proceedings and expert information. Studies conducted in human and published in English language were included in the analysis. All the findings and statements of the review regarding the outbreak are based on published information as listed in citations.

Results

We identified 360 records, of which 50 studies met the inclusion criteria. We synthesized the data from the included records and dig out the deep insights of them and pooled into this review. The burden of the outbreak is worsening due to overcrowding, presence of asymptomatic carriers, scarcity of test kits, the immune escaping ability of the virus and lack of awareness.

Conclusions and recommendations

Due to the fast-spreading nature of COVID-19 the prevention and control strategies become challenging. It is imposing social, psychological, and socio-economic impacts. We recommended that following social distancing, isolation suspects, using personal protective equipment, health education and introducing hand-washing practices, avoiding contact with animals, vaccine development and treatment for controlling and prevention.
Socio-demographic, not environmental, risk factors explain fine-scale spatial patterns of diarrheal disease in Ifanadiana, rural Madagascar
Authors: Evans Michelle V , Bonds Matthew H , Cordier Laura F , Drake John M , Ihantamalala Felana , Haruna Justin , Miller Ann C , Murdock Courtney C , Randriamanambtsoa Marius , Raza-Fanomezanjanahary Estelle M , Razafinjato Bénédicte R. , Garchitorena Andres
Published: April 2020

Diarrheal disease (DD) is responsible for over 700,000 child deaths annually, the majority in the tropics. Due to its strong environmental signature, DD is amenable to precision health mapping, a technique that leverages spatial relationships between socio-ecological variables and disease to predict hotspots of disease risk. However, precision health mapping tends to rely heavily on data collected at coarse spatial scales over large spatial extents. There is little evidence that such methods produce operationally-relevant predictions at sufficiently fine enough spatio-temporal scales (e.g. village level) to improve local health outcomes. Here, we use two fine-scale health datasets (<5 km) collected from a health system strengthening initiative in Ifanadiana, Madagascar and identify socio-ecological covariates associated with childhood DD. We constructed generalized linear mixed models including socio-demographic, climatic, and landcover variables and estimated variable importance via multi-model inference. We find that socio-demographic variables, and not environmental variables, are strong predictors of the spatial distribution of disease risk at both an individual and commune-level spatial scale. Specifically, a child’s age, sex, and household wealth were the primary determinants of disease. Climatic variables predicted strong seasonality in DD, with the highest incidence in the colder, drier months of the austral winter, but did not predict spatial patterns in disease. Importantly, our models account for less than half of the total variation in disease incidence, suggesting that the socio-ecological covariates identified as important via global precision health mapping efforts have reduced explanatory power at the local scale. More research is needed to better define the set of conditions under which the application of precision health mapping can be operationally useful to local public health professionals.
Evidence that higher temperatures are associated with lower incidence of COVID-19 in pandemic state, cumulative cases reported up to March 27, 2020
Authors: Triplett Michael
Published: April 2020

Seasonal temperature variation may impact the trajectories of COVID-19 in different global regions. Cumulative data reported by the World Health Organization, for dates up to March 27, 20201, show association between COVID-19 incidence and regions at or above 30° latitude. Historic climate data also show significant reduction of case rates with mean maximum temperature above approximately 22.5 degrees Celsius. Variance at the local level, however, could not be well explained by geography and temperature. These preliminary findings support continued countermeasures and study of SARS-CoV-2/COVID-19 transmission rates by temperature and humidity.
Face selective patches in marmoset frontal cortex
Authors: Schaeffer David J. , Selvanayagam Janahan , Johnston Kevin D. , Menon Ravi S. , Freiwald Winrich A. , Everling Stefan
Published: April 2020

Primates have evolved the ability transmit important social information through facial expression. In humans and macaque monkeys, socially relevant face processing is accomplished via a distributed cortical and subcortical functional network that includes specialized patches in anterior cingulate cortex and lateral prefrontal cortex, regions usually associated with high-level cognition. It is unclear whether a similar network exists in New World primates, who diverged ~35 million years from Old World primates and have a less elaborated frontal cortex. The common marmoset (Callithrix jacchus) is a small New World primate that is ideally placed to address this question given the complex social repertoire inherent to this species (e.g., observational social learning; imitation; cooperative antiphonal calling). Here, we investigated the existence of a putative high-level face processing network in marmosets by employing ultra-high field (9.4 Tesla) task-based functional MRI (fMRI). We demonstrated that, like Old World primates, marmosets show differential activation in anterior cingulate cortex and lateral prefrontal cortex while they view socially relevant videos of marmoset faces. We corroborate the locations of these frontal regions by demonstrating both functional (via resting-state fMRI) and structural (via cellular-level tracing) connectivity between these regions and temporal lobe face patches. Given the evolutionary separation between macaques and marmosets, our results suggest this frontal network specialized for social face processing predates the separation between Platyrrhini and Catarrhine. These results give further credence to the marmoset as a viable preclinical modelling species for studying human social disorders.
Multi-Fluorescence High-Resolution Episcopic Microscopy (MF-HREM) for Three-Dimensional Imaging of Adult Murine Organs
Authors: Walsh Claire , Holroyd Natalie A. , Finnerty Eoin , Ryan Sean G. , Sweeney Paul W. , Shipley Rebecca J. , Walker-Samuel Simon
Published: April 2020

Three-dimensional microscopy of large biological samples (>0.5 cm3) is transforming biological research. Many existing techniques require trade-offs between image resolution, sample size and method complexity. A simple robust instrument with the potential to perform large volume 3D imaging currently exists in the form of the Optical HREM, however the development of the instrument to date is limited to single fluorescent wavelength imaging with non-specific eosin staining. This work presents developments to realize the potential of the HREM to become Multi-fluorescent High Resolution Episcopic Microscopy (MF-HREM).

MF-HREM is a serial-sectioning and block-facing wide-field fluorescence imaging technique, which does not require tissue clearing or optical sectioning. Multiple developments are detailed in sample preparation and image post-processing to enable multiple specific stains in large samples, and show how these enable segmentation and quantification of the data. The application of MF-HREM is demonstrated in a variety of biological contexts: 3D imaging of whole tumor vascular networks and tumor cell invasion in xenograft tumors up to 7.5 mm3at resolutions of 2.75 μm, quantification of glomeruli volume in the adult mouse kidney, and quantification of vascular networks and white matter track orientation in adult mouse brain.
Increasing testing throughput and case detection with a pooled-sample Bayesian approach in the context of COVID-19
Authors: Noriega Rodrigo , Samore Matthew H.
Published: April 2020

Rapid and widespread implementation of infectious disease surveillance is a critical component in the response to novel health threats. Molecular assays are the preferred method to detect a broad range of pathogens with high sensitivity and specificity. The implementation of molecular assay testing in a rapidly evolving public health emergency can be hindered by resource availability or technical constraints. In the context of the COVID-19 pandemic, the applicability of a pooled-sample testing protocol to screen large populations more rapidly and with limited resources is discussed. A Bayesian inference analysis in which hierarchical testing stages can have different sensitivities is implemented and benchmarked against early COVID-19 testing data. Optimal pool size and increases in throughput and case detection are calculated as a function of disease prevalence. Even for moderate losses in test sensitivity upon pooling, substantial increases in testing throughput and detection efficiency are predicted, suggesting that sample pooling is a viable avenue to circumvent current testing bottlenecks for COVID-19.