bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Assessment of Resident Competency
Authors: Taylor Charles M. , Baer Heather , Edgar Laura , Jenkins Jeffrey G. , Harada Nancy , Helkowski Wendy M. , Zumsteg Jennifer M. , Francisco Gerard E. , Sabharwal Sunil , Hamilton Rita G. , Mallow Michael
Published: November 2020

In 2015, the Accreditation Council for Graduate Medical Education published the Physical Medicine and Rehabilitation Milestones 1.0 as part of the Next Accreditation System. This was the culmination of more than 20 yrs of work on the part of the Accreditation Council for Graduate Medical Education to improve graduate medical education competency assessments. The six core competencies were patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. While providing a good foundation for resident assessment, the Physical Medicine and Rehabilitation Milestones 1.0 was not without faults. With input from program directors, national organizations, and the public, the Physical Medicine and Rehabilitation Milestones 2.0 strives to further advance resident assessment, providing improvements through the integration of the harmonized Milestones and the addition of a supplemental guide.
Neonatal complete Freund's adjuvant-induced inflammation does not induce or alter hyperalgesic priming or alter adult distributions of C-fibre dorsal horn innervation
Authors: Cooper Andrew H. , Hanmer Jenna M. , Chapman Victoria , Hathway Gareth J.
Published: November 2020

Introduction:

Inflammation during the neonatal period can exacerbate pain severity following reinjury in adulthood. This is driven by alterations in the postnatal development of spinal and supraspinal nociceptive circuitry. However, the contribution of alterations in peripheral nociceptor function remains underexplored.

Objectives:

We examined whether neonatal complete Freund's adjuvant (CFA)-induced inflammation induced or altered adult development of hyperalgesic priming (inflammation-induced plasticity in nonpeptidergic C fibres) or altered postnatal reorganization of calcitonin gene-related peptide (CGRP)-expressing and isolectin B4 (IB4)-binding C fibres in the spinal dorsal horn (DH).

Methods:

After intraplantar injection of CFA at postnatal day (P) 1, we assessed mechanical thresholds in adult (P60) rats before and after intraplantar carrageenan. One week later, intraplantar PGE2-induced hypersensitivity persisting for 4 hours was deemed indicative of hyperalgesic priming. CGRP expression and IB4 binding were examined in adult rat DH after CFA.

Results:

P1 CFA did not alter baseline adult mechanical thresholds, nor did it change the extent or duration of carrageenan-induced hypersensitivity. However, this was slower to resolve in female than in male rats. Rats that previously received carrageenan but not saline were primed, but P1 hind paw CFA did not induce or alter hyperalgesic priming responses to PGE2. In addition, CFA on P1 or P10 did not alter intensity or patterns of CGRP or IB4 staining in the adult DH.

Conclusion:

Complete Freund's adjuvant-induced inflammation during a critical period of vulnerability to injury during early postnatal development does not induce or exacerbate hyperalgesic priming or alter the broad distribution of CGRP-expressing or IB4-binding afferent terminals in the adult dorsal horn.
Early Surgical and Long-term Oncological Outcomes of Totally Laparoscopic Near-total Gastrectomy in >150 Cases
Authors: Shin Eun Ju , Gong Chung Sik , Kim Byung Sik , Kim Seon Ok , Ko Chang Seok , Kim Hee Sung
Published: November 2020

Background:

This study aimed to examine the early surgical outcomes and long-term oncological safety of totally laparoscopic near-total gastrectomy for the treatment of upper-third early gastric cancer.

Materials and Methods:

We retrospectively collected and analyzed the data of 167 consecutive patients who underwent totally laparoscopic near-total gastrectomy for upper-third early gastric cancer between January 2008 and May 2018. Data on clinical characteristics and surgical outcomes, including operation time, length of postoperative hospital stay, pathologic findings, and postoperative complications, were obtained. We also analyzed recurrence-free and overall survival rates to evaluate the oncological outcomes.

Results:

The mean operation time was 149.44±37.59 minutes; none of the patients required conversion to laparotomy during surgery. The average postoperative hospital stay was 7.57±5.69 days. On final pathologic analysis, the mean proximal resection margin was 1.97±1.68 cm. No patients had an involved proximal resection margin. Twenty-seven patients (16.17%) had postoperative complications; of them, 6 patients (3.59%) had Clavien-Dindo classification grade 3 or higher complications, all within 1 month. The median follow-up duration was 54.35 months. The 3- and 5-year recurrence-free survival rates were 98.3% and 97.1%, respectively. The overall survival rate was 97.1% at both 3 and 5 years.

Conclusions:

Our study shows that totally laparoscopic near-total gastrectomy is a safe and feasible procedure for treating the upper-third early gastric cancer. Further, in the current study, the procedure demonstrated a favorable oncological outcome for a relatively long follow-up period and large sample size.
No associations between physical activity and clinical outcomes among hospitalized patients with severe COVID-19
Authors: Pinto Ana J. , Goessler Karla F. , Fernandes Alan L. , Murai Igor H. , Sales Lucas P. , Reis Bruna Z. , Santos Mayara Diniz , Roschel Hamilton , Pereira Rosa M. R. , Gualano Bruno
Published: November 2020

Purpose

This small-scale, prospective cohort study nested within a randomized controlled trial aimed to investigate the possible associations between physical activity levels and clinical outcomes among hospitalized patients with severe COVID-19.

Methods

Hospitalized patients with severe COVID-19 were recruited from Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital), and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. Physical activity levels were assessed by Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were: mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement.

Results

Mean hospital length of stay was 8.5 ± 7.1 days; 3.3% of patients died, 13.8% were admitted to ICU, and 8.6% required mechanical ventilation. Linear regression models showed that physical activity indexes were not associated with hospital length of stay (work index: β=-0.57 [95%CI: −1.80 to 0.65], p=0.355; sport index: β=0.43 [95%CI: −0.94 to 1.80], p=0.536; leisure-time index: β=1.18 [95%CI: −0.22 to 2.59], p=0.099; total activity index: β=0.20 [95%CI: −0.48 to 0.87], p=0.563. Physical activity indexes were not associated with mortality, admission to ICU and mechanical ventilation requirement (all p>0.05).

Conclusions

Among hospitalized patients with COVID-19, physical activity did not associate with hospital length of stay or any other clinically-relevant outcomes. These findings suggest that previous physical activity levels may not change the prognosis of severe COVID-19.
“I don’t feel safe sitting in my own yard”: Chicago resident experiences with urban rats during a COVID-19 stay-at-home order
Authors: Murray Maureen H. , Byers Kaylee A. , Buckley Jacqueline , Magle Seth B. , Maffei Dorothy , Waite Preeya , German Danielle
Published: November 2020

Background

Encounters with rats in urban areas increase risk of human exposure to rat-associated zoonotic pathogens and act as a stressor associated with psychological distress. The frequency and nature of human-rat encounters may be altered by social distancing policies to mitigate the COVID-19 pandemic. For example, restaurant closures may reduce food availability for rats and promote rat activity in nearby residential areas, thus increasing public health risks during a period of public health crisis. In this study, we aimed to identify factors associated with increased perceived exposure to rats during a stay-at-home order, describe residents’ encounters with rats relevant to their health and well-being, and identify factors associated with increased use of rodent control.

Methods

Urban residents in Chicago, a large city with growing concerns about rats and health disparities, completed an online questionnaire including fixed response and open-ended questions during the spring 2020 stay-at-home order. Analyses included ordinal multivariate regression, spatial analysis, and thematic analysis for open-ended responses.

Results

Overall, 21% of respondents (n=835) reported an increase in rat sightings around their homes during the stay-at-home order and increased rat sightings was positively associated with proximity to restaurants, low-rise apartment buildings, and rat feces in the home (p≤0.01). Many respondents described feeling unsafe using their patio or yard, and afraid of rats entering their home or spreading disease. Greater engagement with rodent control was associated with property ownership, information about rat control, and lower incomes (p≤0.01).

Conclusions

More frequent rat encounters may be an unanticipated public health concern during periods of social distancing, especially in restaurant-dense areas or in low-rise apartment buildings. Rat presence may also limit residents’ ability to enjoy nearby outdoor spaces, which otherwise might buffer stress experienced during a stay-at-home order. Proactive rat control may be needed to mitigate rat-associated health risks during future stay-at-home orders.
Impact of the COVID-19 pandemic on developmental care practices for infants born preterm
Authors: Scala Melissa , Marchman Virginia A. , Brignoni-Pérez Edith , Morales Maya Chan , Travis Katherine E.
Published: November 2020

Objectives

To assess the impact of the COVID-19 pandemic on rates of hospital visitation and rates and durations of developmental care practices for infants born preterm delivered by both families and clinical staff.

Methods

We analyzed electronic medical record data from infants born at less than 32 weeks gestational age (GA) cared for in the Lucile Packard Children’s Hospital neonatal intensive care unit (NICU) in a COVID-19-affected period (March 8, 2020 to May 31, 2020) and the analogous period in 2019. Our final sample consisted of 52 infants (n=27, 2019 cohort; n=25, 2020 cohort). Rates of family visitation and of family- and clinical staff-delivered developmental care were compared across cohorts, adjusting for GA at start of study period.

Results

Results indicated that families of infants in the 2020 cohort visited less frequently (47% of available days) than those in the 2019 cohort (97%; p=0.001). Infants received developmental care activities less frequently in the 2020 cohort (3.51 vs. 4.72 activities per day; p=0.04), with a lower number of minutes per day (99.91 vs. 145.14; p=0.04) and a shorter duration per instance (23.41 vs. 29.65; p=0.03). Similar reductions occurred in both family- and staff-delivered developmental care activities.

Conclusions

The COVID-19 pandemic has negatively impacted family visitation and preterm infant developmental care practices in the NICU, both experiences associated with positive health benefits. Hospitals should create programs to improve family visitation and engagement, while also increasing staff-delivered developmental care. Careful attention should be paid to long-term follow up of preterm infants and families.
The association of smoking status with hospitalisation for COVID-19 compared with other respiratory viruses a year previous: A case-control study at a single UK National Health Service trust
Authors: Simons David , Perski Olga , Shahab Lion , Brown Jamie , Bailey Robin
Published: November 2020

Background

It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We examined i) the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory viral infections a year previous; and ii) concordance between smoking status recorded on the electronic health record (EHR) and the contemporaneous medical notes.

Methods

This case-control study enrolled adult patients (446 cases and 211 controls) at a single National Health Service trust in London, UK. The outcome variable was type of hospitalisation (COVID-19 vs. another respiratory virus a year previous). The exposure variable was smoking status (never/former/current smoker). Logistic regression analyses adjusted for age, sex, socioeconomic position and comorbidities were performed. The study protocol and analyses were pre-registered in April 2020 on the Open Science Framework.

Results

Current smokers had lower odds of being hospitalised with COVID-19 compared with other respiratory viruses a year previous (ORadj=0.55, 95% CI=0.31-0.96, p=.04). There was no significant association among former smokers (ORadj=1.08, 95% CI=0.72-1.65, p=.70). Smoking status recorded on the EHR (compared with the contemporaneous medical notes) was incorrectly recorded for 168 (79.6%) controls (χ2(3)=256.5, p=<0.001) and 60 cases (13.5%) (χ2(3)=34.2, p=<0.001).

Conclusions

In a single UK hospital trust, current smokers had reduced odds of being hospitalised with COVID-19 compared with other respiratory viruses a year previous, although it is unclear whether this association is causal. Targeted post-discharge recording of smoking status may account for the greater EHR- medical notes concordance observed in cases compared with controls.
Incidence and prognostic factors of knee extension deficits following anterior cruciate ligament reconstruction: A systematic review and meta-analysis of randomised controlled trials
Authors: Scholes Corey , Ektas Nalan , Harrison-Brown Meredith , Jegatheesan Maha , Rajesh Ashwin , Kirwan Garry , Bell Christopher
Published: November 2020

Background and aims

Knee extension deficits complicate recovery from ACL injury and reconstruction, however the incidence of knee extension loss is not well defined. The aim of this review was to identify the incidence of loss of extension (LOE) following ACL rupture and reconstruction, explore the definitions of knee extension deficits reported and identify prognostic factors affecting LOE incidence.

Methods and analysis

A systematic search was conducted in Medline, Cochrane Library and PEDro for studies in publication up to November 2021, with no restrictions on publication year. References were screened and assessed for inclusion using predetermined eligibility criteria. Randomised controlled trials (RCTs) that quantified knee angle, loss of extension or incidence of extension deficit were included for quality assessment and data extraction. Statistical summaries were generated and meta-analyses performed in two parts to examine: (i) the probability of a datapoint being zero incidence compared to a non-zero incidence, and (ii) the relationship between the predictors and non-zero LOE incidence.

Results

A sample of 15494 papers were retrieved using the search criteria, with 53 studies meeting eligibility criteria. Pooled results from 4991 participants were included for analysis, with 4891 participants who had undergone ACLR. The proportion of included studies judged at an overall low risk of bias was small (7.8%). The observed group and study were the most important predictors for whether a datapoint reported an incidence of extension deficit. Time to follow up (P < 0.001) and graft type (P = 0.02) were found to have a significant influence on non-zero LOE incidence (%). Covariate adjusted estimates of average LOE indicated 1 in 3 patients presenting with LOE at 12months followup, reducing to 1 in 4 at 2 years.

Conclusions

This review examined the definitions for the measurement and interpretation of postoperative knee extension, and established the trajectory of knee extension deficit after ACL injury and reconstruction. While factors associated with loss of extension were identified, the exact trajectory of knee extension deficits were difficult to infer due to discrepancies in measurement techniques and patient variation. Clinicians should expect up to 1 in 3 patients to present postoperatively with loss of extension of at least 3 degrees, which may resolve in some patients over time. Future work should focus on LOE as a clinically relevant complication of ACL injury and treatment with appropriate attention to standardisation of definitions, measurements and better understanding of natural history.

PROSPERO registration number

CRD42018092295
Comparison of epicardial adipose tissue volume quantification between cardiac and chest computed tomography scans
Authors: Xu Lingyu , Xu Yuancheng , Hrybouski Stanislau , Paterson D Ian , Thompson Richard B. , Li Zhiyang , Lan Yulong , Butler Craig
Published: November 2020

Background

This study investigated accuracy and consistency of epicardial adipose tissue (EAT) quantification in chest computed tomography (CT) scans.

Methods and results

EAT volume was quantified semi-automatically using a standard Hounsfield unit threshold (-190U, -30) in three independent cohorts: (1) Cohort 1 (N= 30) consisted of paired 120 KV cardiac non-contrast CT (NCCT) and 120 KV chest NCCT; (2) Cohort 2 (N= 20) consisted of paired 120 KV cardiac NCCT and 100 KV chest NCCT; (3) Cohort 3 (N= 20) consisted of paired chest NCCT and chest contrast-enhanced CT (CECT) datasets. Images were reconstructed with the slice thicknesses of 1.25 mm and 5 mm in the chest CT datasets, and 3 mm in the cardiac NCCT datasets. In Cohort 1, the chest NCCT-1.25 mm EAT volume was similar to the cardiac NCCT EAT volume, whilst chest NCCT-5 mm underestimated the EAT volume by 7.0%. In Cohort 2, 100 KV chest NCCT-1.25mm and -5 mm EAT volumes were 9.7% and 6.4% larger than corresponding 120 KV cardiac NCCT EAT volumes. In Cohort 3, the chest CECT dataset underestimated EAT volumes by ∼25%, relative to chest NCCT datasets. All chest CT-derived EAT volumes were strongly correlated with their cardiac CT counterparts.

Conclusions

The chest NCCT-1.25 mm EAT volume with the 120 KV tube energy produced EAT volumes that are comparable to cardiac NCCT. All chest CT EAT volumes were strongly correlated with EAT volumes obtained from cardiac CT, if imaging protocol is consistently applied to all participants.
I’m alone but not lonely. U-shaped pattern of perceived loneliness during the COVID-19 pandemic in the UK and Greece
Authors: Carollo Alessandro , Bizzego Andrea , Gabrieli Giulio , Wong Keri Ka-Yee , Raine Adrian , Esposito Gianluca
Published: November 2020

Many countries have adopted lengthy lockdown measures to mitigate the spreading of the COVID-19 virus. In this study, we train a RandomForest model using 10 variables quantifying individuals’ living environment, physical and mental health statuses to predict how long each of the UK participants (N=382) had been in lockdown. Self-perceived loneliness was found to be the most important variable predicting time in lockdown and, therefore, the aspect most influenced by the time the participant spent in lockdown. Subsequent statistical analysis showed a significant U-shaped curve for the levels of perceived loneliness (p<0.012), specifically decreasing during the 4th and 5th lockdown weeks. The same pattern was found on data from Greek citizens (N=129, p<0.041). These results suggest that lockdown measures may have affected how people evaluated their social support while in lockdown, leading to a decreased sense of loneliness. Implications of this study should be reflected on policies and countermeasures to current and future pandemics.

State of relevance

This study aims to inform policies for the current and/or future pandemics, particularly those involving lockdown restrictions. It highlights that self-perceived loneliness was the trait most affected by the time spent in lockdown: data show that the very first period of lockdown was characterised by a decrease in levels of perceived loneliness. The machine learning approach adopted and the statistical validation on two different Western European countries ensure that the uncovered pattern is substantial. This result highlights the dissociation between objective social support and perceived loneliness: initially, restrictions may have triggered better social behaviours among communities or increased the level of gratitude for the social support people have always received. The short duration of these desirable effects suggests that measures and campaigns promoting better social support strategies could be potentially effective, even in social isolation, to keep the levels of perceived loneliness low.
Altered smell and taste: anosmia, parosmia and the impact of long Covid-19
Authors: Burges Watson Duika L , Campbell Miglena , Hopkins Claire , Smith Barry , Kelly Chris , Deary Vincent
Published: November 2020

Background

Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell.

Methods

We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020.

Results

Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others.

Conclusions

Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people’s sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.
Increased Prescribing of Psychotropic Medications to Ontario Nursing Home Residents during the COVID-19 Pandemic
Authors: Stall Nathan M. , Zipursky Jonathan S. , Rangrej Jagadish , Jones Aaron , Costa Andrew P. , Hillmer Michael P. , Brown Kevin
Published: November 2020

In this population-based study of all Ontario nursing home residents, we found increased prescribing of psychotropic drugs at the onset of the COVID-19 pandemic that persisted through September 2020. Increases in prescribing were out of proportion to expected secular trends, and distinct from observed prescribing changes in other drugs during the pandemic. Our findings underscore the urgency of balancing infection prevention and control measures in nursing homes with the mental wellbeing of residents.
Individual participant data systematic reviews with meta-analyses of psychotherapies for borderline personality disorder: A protocol
Authors: Storebø Ole Jakob , Ribeiro Johanne Pereira , Kongerslev Mickey T. , Stoffers-Winterling Jutta , Jørgensen Mie Sedoc , Lieb Klaus , Bateman Anthony , Kirubakaran Richard , Dérian Nicolas , Karyotaki Eirini , Cuijpers Pim , Simonsen Erik
Published: November 2020

Introduction

The heterogeneity in people with BPD and the range of specialised psychotherapies means that people with certain BPD characteristics might benefit more or less from different types of psychotherapy. Identifying moderating characteristics of individuals is a key to refine and tailor standard treatments so they match the specificities of the individual patient. The objective of this is to improve the quality of care and the individual outcomes. Thus, the aim of the current reviews is to investigate potential predictors and moderating patient characteristics on treatment outcomes for patients with BPD.

Methods and analysis

Our primary meta-analytic method will be the one-stage random-effects approach. To identify predictors, we will be using the one-stage model that accounts for interaction between covariates and treatment allocation. Heterogeneity in case-mix will be assessed using a membership model based on a multinomial logistic regression where study membership is the outcome. A random-effects meta-analysis is chosen to account for expected levels of heterogeneity.

Ethics and dissemination

The statistical analyses will be conducted on anonymised data that have already been approved by the respective ethical committees that originally assessed the included trials. The three IPD reviews will be published in high impact factor journals and their results will be presented at international conferences and national seminars.

Protocol registration

The IPD reviews, described in this study protocol, are registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number: awaiting)

Strengths and limitations of this protocol

These IPD-reviews are the first to systematically review and investigate psychotherapy for people with borderline personality disorder using individual participant data.

The IPD-reviews will provide information on moderators and predictors in patients with borderline personality disorder that predict who may benefit most from which type of specialised psychotherapy.

Individual participant data allows for a more precise risk of bias assessment and decreases the amount of unclear risk of bias in many of the included trials.

A limitation to IPD-reviews in general is that data retrieval can be challenging.

The IPD-reviews are limited to the outcomes and patient characteristics that have been assessed in the included trials.
Saliva, a relevant alternative sample for SARS-CoV2 detection
Authors: Costa Monique Melo , Benoit Nicolas , Dormoi Jerome , Amalvict Remy , Gomez Nicolas , Tissot-Dupont Hervé , Million Matthieu , Pradines Bruno , Granjeaud Samuel , Almeras Lionel
Published: November 2020

Background

Currently, COVID-19 diagnosis relies on quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) from nasopharyngeal swab (NPS) specimens, but NPSs present several limitations. The simplicity, low invasive and possibility of self-collection of saliva imposed this specimen as a relevant alternative for SARS-CoV-2 detection. However, the discrepancy of saliva test results compared to NPSs made of its use controversial. Here, we proposed to assess Salivettes®, as a standardized saliva collection device, and to compare SARS-CoV-2 positivity on paired NPS and saliva specimens.

Methods

A total of 303 individuals randomly selected among those investigated for SARS-CoV-2 were enrolled, including 30 (9.9%) patients previously positively tested using NPS (follow-up group), 90 (29.7%) mildly symptomatic and 183 (60.4%) asymptomatic.

Results

The RT-qPCR revealed a positive rate of 11.6% (n=35) and 17.2% (n=52) for NPSs and saliva samples, respectively. The sensitivity and specificity of saliva samples were 82.9% and 91.4%, respectively, using NPS as reference. The highest proportion of discordant results concerned the follow-up group (33.3%). Although in the symptomatic and asymptomatic groups the agreement exceeded 90.0%, 17 individuals were detected positive only in saliva samples, with consistent medical arguments.

Conclusion

Saliva collected with Salivette® demonstrated more sensitive for detecting symptomatic and pre-symptomatic infections.
Epigenetic predictors of lifestyle traits applied to the blood and brain
Authors: Gadd Danni A. , Stevenson Anna J. , Hillary Robert F. , McCartney Daniel L. , Wrobel Nicola , McCafferty Sarah , Murphy Lee , Russ Tom C. , Harris Sarah E. , Redmond Paul , Taylor Adele M. , Smith Colin , Rose Jamie , Millar Tracey , Spires-Jones Tara L. , Cox Simon R. , Marioni Riccardo E.
Published: November 2020

Modifiable lifestyle factors influence the risk of developing many neurological diseases. These factors have been extensively linked with blood-based genome-wide DNA methylation (DNAm), but it is unclear if the signatures from blood translate to the target tissue of interest - the brain. To investigate this, we apply blood-derived epigenetic predictors of four lifestyle traits to genome-wide DNAm from five post-mortem brain regions and the last blood sample prior to death in 14 individuals in the Lothian Birth Cohort 1936 (LBC1936). Using these matched samples, we found that correlations between blood and brain DNAm scores for smoking, high density lipoprotein (HDL) cholesterol, alcohol and body mass index (BMI) were highly variable across brain regions. Smoking scores in the dorsolateral prefrontal cortex had the strongest correlations with smoking scores in blood (r=0.5, n=14) and smoking behaviour (r=0.56, n=9). This was also the brain region which exhibited the strongest correlations for DNAm at site cg05575921 - the single strongest correlate of smoking in blood - in relation to blood (r=0.61, n=14) and smoking behaviour (r=-0.65, n=9). This suggested a particular vulnerability to smoking-related differential methylation in this region. Our work contributes to understanding how lifestyle factors affect the brain and suggests that lifestyle-related DNAm is likely to be both brain region dependent and in many cases poorly proxied for by blood. Though these pilot data provide a rarely-available opportunity for the comparison of methylation patterns across multiple brain regions and the blood, due to the limited sample size available our results must be considered as preliminary and should therefore be used as a basis for further investigation.

Abstract Figure

Graphical abstract 203mm x 127mm (DPI 300)

Abbreviated summary [50 words]: We apply blood-derived epigenetic signatures of lifestyle traits to matched blood and brain samples, uncovering variability in how well blood translates across brain regions and a relationship between smoking and the prefrontal cortex. Our preliminary results contribute to understanding how lifestyle-related DNA methylation affects the brain in health and disease.
Comparative genomic study for revealing the complete scenario of COVID-19 pandemic in Bangladesh
Authors: Ahammad Ishtiaque , Hossain Mohammad Uzzal , Rahman Anisur , Chowdhury Zeshan Mahmud , Bhattacharjee Arittra , Das Keshob Chandra , Keya Chaman Ara , Salimullah Md.
Published: November 2020

As the COVID-19 pandemic continues to ravage across the globe and take millions of lives and like many parts of the world, the second wave of the pandemic hit Bangladesh, this study aimed at understanding its causative agent, SARS-CoV-2 at the genomic and proteomic level and provide precious insights about the pathogenesis, evolution, strengths and weaknesses of the virus. As of Mid-June 2021, over 1500 SARS-CoV-2 genomes have been sequenced across the country. From our analyses, it was discovered that the wave-2 samples had a significantly greater average rate of mutation/sample (30.79%) than the wave-1 samples (12.32%). Wave-2 samples also had a higher frequency of deletion, and transversion events. During the first wave, the GR clade was the most predominant but it was replaced by the GH clade in the latter wave. The B.1.1.25 variant showed the highest frequency in wave-1 while in case of wave-2, the B.1.351.3 variant, was the most common one. A notable presence of the delta variant, which is currently at the center of concern, was also observed. Comparison of the Spike protein found in the reference and the 3 most common lineages found in Bangladesh namely, B.1.1.7, B.1.351, B.1.617 in terms of their ability to form stable complexes with ACE2 receptor revealed that B.1.617 had the potential to be more transmissible than others. Importantly, no indigenous variants have been detected so far which implies that the successful prevention of import of foreign variants can diminish the outbreak in the country.
The newly introduced SARS-CoV-2 variant A222V is rapidly spreading in Lazio region, Italy
Authors: Bartolini Barbara , Rueca Martina , Gruber Cesare Ernesto Maria , Messina Francesco , Giombini Emanuela , Ippolito Giuseppe , Capobianchi Maria Rosaria , Di Caro Antonino
Published: November 2020

A new SARS-CoV-2 clade (GV) characterized by S substitution A222V, first reported from Spain in March, is rapidly spreading across Europe. To establish the A222V variant involvement in the infection rise in Italy, all GISAID sequences from Italy and those from our Laboratory (Lazio) in the period June-October were analysed. A222V, first recognized in August, represents 11.2% of sequences in this period, reaching 100% of autochthonous sequences in October, supporting increased GV circulation in Italy.
Prevalence of IgG antibodies against SARS-CoV-2 among healthcare workers in a tertiary pediatric hospital in Poland
Authors: Kasztelewicz Beata , Janiszewska Katarzyna , Burzyńska Julia , Szydłowska Emilia , Migdał Marek , Dzierżanowska-Fangrat Katarzyna
Published: November 2020

Data on prevalence of SARS-CoV-2 antibody in healthcare workers (HCWs) is scare, especially in pediatric settings. The purpose of this study was to evaluate the SARS-CoV-2 IgG-positivity among HCWs of a tertiary pediatric hospital. In addition, follow-up of serological response in the subgroup of seropositive HCWs was performed, to get some insight on persistence of IgG antibodies to SARS-CoV-2. Free, voluntary SARS-CoV-2 IgG testing was made available to HCWs of the Children’s Memorial Health Institute in Warsaw (Poland). Plasma samples were collected between July 1 and August 9, 2020 and tested using the Abbott SARS-CoV-2 IgG assay. Of 2282 eligible participants, 1879 (82.3%) HCWs volunteered to undergo testing. Sixteen HCWs tested positive for SARS-CoV-2 IgG, corresponding to the seroprevalence of 0.85%. Among seropositive HCWs, three had confirmed COVID-19. Of note, 8 (50%) seropositive HCWs reported neither symptoms nor unprotected contact with confirmed SARS-CoV-2 cases in the previous months. A decline in the IgG index was observed at median time of 86.5 days (range:84-128 days) after symptom onset or RT-PCR testing. The nationwide public health response measures together with infection prevention and control practices implemented at the hospital level, at the beginning of the COVID-19 pandemic, might explain a low seroprevalence. Further studies are warranted to elucidate the duration of anti-SARS-CoV-2 antibodies, as well as the correlation between seropositivity and protective immunity against reinfection. Regardless of the persistence of antibodies and their protective properties, such low prevalence indicates that this population is vulnerable to a second wave of the COVID-19 pandemic.
Medical emoji for clinical signs and symptoms: a comprehensive qualitative study
Authors: Assadi Reza , Lotfinejad Nasim , Ziae Amir Hosein , Ganjali Baran
Published: November 2020

Introduction

Emojis have surpassed facial expressions and they are now widely used to deliver complex concepts by representing graphical expressions in the digital platform. In this study, we endeavored to develop medical emojis for clinical signs and symptoms to be used as tools for text-based counselling.

Methods

The present study was conducted using the Delphi method with medical studnets and general practitioners, drawing and discussing in several repeated rounds. For this purpose, about 100 clinical signs/symptoms were considered using the ICD-10 website.

Results

In the present study, from one hundred signs and symptoms we reached to 85 signs/symptoms that after first round of sessions were illustrated. Out of these 85 eligible emojis, 4 cases were removed due to the lack of consensus. The rest of the emojis were finalized and prepared by the graphic designer. These emojis then were published online to collect online votes.

Conclusion

In this study, we could design up to 81 medical emojis presenting clinical sign and symptoms with acceptable consensus between the participants. These emojis were reasonably acceptable by our panelists in presenting the established clinical concepts.
3D printed biomimetic cochleae and machine learning co-modelling provides clinical informatics for cochlear implant patients
Authors: Lei Iek Man , Jiang Chen , Lei Chon Lok , Rijk Simone Rosalie de , Tam Yu Chuen , Swords Chloe , Sutcliffe Michael P.F. , Malliaras George G. , Bance Manohar , Huang Yan Yan Shery
Published: November 2020

Cochlear implants (CIs) restore hearing in patients with severe to profound deafness by delivering electrical stimuli inside the cochlea. Understanding CI stimulus spread, and how it correlates to patient-dependent factors, is hampered by the poor accessibility of the inner ear and by the lack of suitablein vitro, in vivoorin silicomodels. Here, we present 3D printing-neural network co-modelling for interpreting clinical electric field imaging (EFI) profiles of CI patients. With tuneable electro-anatomy, the 3D printed cochleae were shown to replicate clinical scenarios of EFI profiles at the off-stimuli positions. The co-modelling framework demonstrated autonomous and robust predictions of patient EFI or cochlear geometry, unfolded the electro-anatomical factors causing CI stimulus spread, assisted on-demand printing for CI testing, and inferred patients’in vivocochlear tissue resistivity (estimated mean = 6.6 kΩcm) by CI telemetry. We anticipate our framework will facilitate physical modelling and digital twin innovations for electrical prostheses in healthcare.
Seroprevalence of anti-SARS-COV-2 antibodies in blood donors from Nuevo Leon state, Mexico, during the beginning of the COVID-19 pandemic
Authors: Martinez-Acuña Natalia , Avalos-Nolazco Diana , Rodriguez-Rodriguez Diana , Martinez-Liu Cynthia , Taméz Rogelio Cazares , Flores-Arechiga Amador , Perez-Chavez Fernando , Ayala-de-la-Cruz Sergio , Cienfuegos-Pecina Eduardo , Diaz-Chuc Erik , Arellanos-Soto Daniel , Padilla-Rivas Gerardo , Ramos-Jimenez Javier , Galan-Huerta Kame , Lozano-Sepulveda Sonia , Garza-González Elvira , Treviño-Garza Consuelo , Montes-de-Oca-Luna Roberto , Lee Aurora Beatriz , de-la-O-Cavazos Manuel , Rivas-Estilla Ana Maria
Published: November 2020

Background

The progression and distribution of SARS-CoV-2 is unknown because typically only symptomatic individuals are diagnosed.

Aim

We evaluated the seroprevalence of anti-SARS-CoV-2 in blood donors in Nuevo Leon, Mexico as a strategy for asymptomatic case detection of COVID-19 and epidemic progression.

Methods/Materials

We tested 1968 blood donors that attended two regional donation centers in Northeast Mexico from January 1st to August 30, 2020, to identify anti-SARS-CoV-2 IgG by chemiluminescent immunoassay. Additionally, routine tests for donors including Brucella, Chagas, HCV, VDRL, HIV-1, and HBsAg identification were performed.

Results

We found 77 donors reactive for anti-SARS-CoV-2 IgG (seroprevalence 3.99%) and none of them had reported recent COVID-19 symptoms. Donors aged 18 to 49 years (89.5%) were more likely to be seropositive compared to those aged 50 years or older (10.5%) (P<0.001). Prevalence of antibodies increased each epidemiological (EPI) week, parallel to the report of confirmed cases by RT-PCR, identifying the highest prevalence between EPI week 33 and 35 (10.2% to 19%). The metropolitan area of Monterrey recorded the highest number of cases. Routine tests showed that the prevalence of anti-Brucella was 0.13%, anti-HCV 0.5%, anti-HIV-1-2 0.14%, HBsAg 0.16%, Chagas 0.48% and syphilis 1.06%.

Conclusions

There is a growing trend of seroprevalence over time, parallel to the constantly increasing epidemic curve in our region and it was higher under 49 years of age associated with asymptomatic infection in donors from the Nuevo Leon area. Detection of anti-SARS-CoV-2 in blood donors is a potential tool for tracking the progression and identifying population exposure during the SARS-CoV-2 outbreak.
Measuring Voluntary Responses in Healthcare Utilization During the COVID-19 Pandemic: Evidence from Taiwan
Authors: Tsai Yung-Yu , Yang Tzu-Ting
Published: November 2020

Healthcare has been one of the most affected sectors during the coronavirus disease 2019 (COVID-19) pandemic. The utilization of related services for non-COVID-19 diseases fell dramatically following the point at which the virus broke out; however, little is known about whether this observed decline in healthcare use was due to voluntary behaviors or enforced measures. This paper quantifies the spontaneous change in healthcare utilization during the pandemic. We utilize a county-by-week-level dataset from Taiwan’s National Health Insurance (NHI) record, covering the entire Taiwanese population, and a difference-in-differences design. Our results indicate that even if there were no human mobility restrictions or supply-side constraints, people voluntarily reduced their demand for healthcare, due to fears of contagion, or COVID-related precautionary behaviors. We find that the number of outpatient visits (inpatient admissions) decreased by 21% (11%) during the pandemic period (February to May 2020). Furthermore, the demand response of healthcare for Influenza-like illness (ILI) was much greater and more persistent than for non-ILI, thereby suggesting that the substantial decline in accessing healthcare was induced by positive public health externality of prevention measures for COVID-19. Finally, we find that the demand for healthcare services did not get back to the pre-pandemic baseline, even when there were no local coronavirus cases for 253 consecutive days (mid-April to December 2020) in Taiwan.
Prevalence, Patterns and Predictors of physical activity in Urban Population of Bhubaneswar smart city, India
Authors: Mohanty Satyajit , Sahoo Jyotiranjan , Venkatarao Epari , Shankar G Ganesh , Panigrahi Sandeep Kumar
Published: November 2020

Background

Physical inactivity is a risk factor for mortality and morbidity. Physical activity and its predictors among urban population in this part of the country was unknown. Finding physical inactivity as a cause of current noncommunicable diseases (NCD) is difficult.

Objectives

To find out the prevalence, patterns and predictors of physical activity in urban population, and investigate its causal relationship with NCD.

Materials and methods

It was a cross-sectional study using cluster random sampling. Sample size was 1203. Socio-demographic, health profile, physical activity levels, and stage of change for physical activity behaviour were collected. was used for analysis. Logistic regression and marginal structural model analysis (by IPTW) were done using IBM SPSS 20.0.Statistical significance were tested at p=0.05.

Results

1221 subjects participated. Mean age was 35.25 years. 71.9% were physically inactive, 15.9% practised ‘yogasana’. General caste, presence of NCD, being in a static stage of change and a yogassana practitioner influenced physical activity positively. Physical inactivity had 1.54 times higher odds for NCD and was statistically significant.

Conclusion

Prevalence of physical activity was low. Physical inactivity was a causative factor for NCD.
Preferences and barriers to mental help seeking among students attending the University of Dschang, West region, Cameroon
Authors: Pianta Martial Sonkoue , Eba Ze Linda Evans , Miranda Baame Esong , Tah Rene Mih , Kadia Benjamin Momo
Published: November 2020

Background

Mental disorders are a major source of disability and receive little attention in developing countries in general and particularly in Cameroon. Students are at a higher risk of developing mental disorders. The aim of this study was to assess students’ mental help seeking preferences and the barriers to mental health seeking.

Methods

We conducted a cross sectional study. Participants were selected using a multistage sampling method. A self-administered questionnaire was used to collect data on sociodemographic characteristics preferences and barriers to mental health seeking.

Results

Of the 84.23%[534/634, CI :81.18%- 86.86%] who consider depression a serious health problem 34.14%[183/534, CI : 30,25%- 38.26%] will go to a psychologist, in case of a mental health problem.. Most of the participants 47.32% [300/634,CI : 43,46%- 51.21%] prefer a private hospital for healthcare. The greatest barrier to health access is the inability to pay 38.64%[245/634, CI : 34.93%- 42.49%].

Conclusion

Interventions to increase awareness on available health services, implementation of universal health coverage and the promotion of mental health could greatly improve health seeking behaviour and access to mental healthcare.
A psychrometric model to predict the biological decay of the SARS-CoV-2 virus in aerosols
Authors: Beggs Clive B. , Avital Eldad J.
Published: November 2020

There is increasing evidence that the 2020 COVID-19 pandemic has been influenced by variations in air temperature and humidity. However, the impact that these environmental parameters have on survival of the SARS-CoV-2 virus has not been fully characterised. Therefore an analytical study was undertaken using published data to develop a psychrometric model to predict the biological decay rate of the virus in aerosols. This revealed that it is possible to predict with a high degree of accuracy (R2= 0.718, p<0.001) the biological decay constant for SARS-CoV-2 using a regression model with enthalpy, vapour pressure and specific volume as predictors. Applying this to historical meteorological data from London, Paris and Milan over the pandemic period, produced results which indicate that the average half-life of the virus in aerosols was in the region 13-21 times longer in March 2020, when the outbreak was accelerating, than it was in August 2020 when epidemic in Europe was at its nadir. As such, this suggests that changes in virus survivability due the variations in the psychrometric qualities of the air might influence the transmission of COVID-19.