bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective SARS-CoV-2 cohort study among primary health care providers during the second COVID-19 wave in Flanders, Belgium
Authors: Mariën Joachim , Ceulemans Ann , Bakokimi Diana , Lammens Christine , Ieven Margareta , Heytens Stefan , De Sutter An , Verbakel Jan Y , Van den Bruel Ann , Goossens Herman , Van Damme Pierre , Ariën Kevin K , Coenen Samuel
Published: July 2021

Background

Primary health care providers (PHCPs) are assumed to be at high risk of a COVID-19 infection, as they are exposed to patients with usually less personal protective equipment (PPE) than other frontline health care workers (HCWs). Nevertheless, current research efforts focussed on the assessment of COVID-19 seroprevalence rates in the general population or hospital HCWs.

Objective

We aimed to determine the seroprevalence in PHCPs during the second SARS-CoV-2 wave in Flanders (Belgium) and compared it to the seroprevalence in the general population. We also assessed risk factors, availability of PPE and attitudes towards the government guidelines over time.

Methods

A prospective cohort of PHCPs (n = 698), mainly general practitioners, was asked to complete a questionnaire and self-sample capillary blood by finger-pricking at five distinct points in time (June–December 2020). We analysed the dried blood spots for IgG antibodies using a Luminex multiplex immunoassay.

Results

The seroprevalence of PHCPs remained stable between June and September (4.6–5.0%), increased significantly from October to December (8.1–13.4%) and was significantly higher than the seroprevalence of the general population. The majority of PHCPs were concerned about becoming infected, had adequate PPE and showed increasing confidence in government guidelines.

Conclusions

The marked increase in seroprevalence during the second COVID-19 wave shows that PHCPs were more at risk during the second wave compared to the first wave in Flanders. This increase was only slightly higher in PHCPs than in the general population suggesting that the occupational health measures implemented provided sufficient protection when managing patients.
Genome assembly of primitive cultivated potato Solanum stenotomum provides insights into potato evolution
Authors: Yan Lang , Zhang Yizheng , Cai Guangze , Qing Yuan , Song Jiling , Wang Haiyan , Tan Xuemei , Liu Chunsheng , Yang Mengping , Fang Zhirong , Lai Xianjun
Published: July 2021

Genetic diversity is the raw material for germplasm enhancement. Landraces and wild species relatives of potato, which contain a rich gene pool of valuable agronomic traits, can provide insights into the genetic diversity behind the adaptability of the common potato. The diploid plant, Solanum stenotomum (Sst), is believed to have an ancestral relationship with modern potato cultivars and be a potential source of resistance against disease. Sequencing of the Sst genome generated an assembly of 852.85 Mb (N50 scaffold size, 3.7 Mb). Pseudomolecule construction anchored 788.75 Mb of the assembly onto 12 pseudochromosomes, with an anchor rate of 92.4%. Genome annotation yielded 41,914 high-confidence protein-coding gene models and comparative analyses with closely related Solanaceae species identified 358 Sst-specific gene families, 885 gene families with expansion along the Sst lineage, and 149 genes experiencing accelerated rates of protein sequence evolution in Sst, the functions of which were mainly associated with defense responses, particularly against bacterial and fungal infection. Insights into the Sst genome and the genomic variation of cultivated potato taxa are valuable in elaborating the impact of potato evolution in early landrace diploid and facilitate modern potato breeding.
Local Environment Action on Food project: impact of a community-based food environment intervention in Canada
Authors: Aylward Breanne L , Milford Krista M , Storey Kate E , Nykiforuk Candace I J , Raine Kim D
Published: July 2021

Children are exposed to food environments that make nutrient-poor, energy-dense food cheap, readily available and heavily marketed; all conditions with potential negative impacts on diet and health. While the need for programmes and policies that improve the status of food environments is clear, greater public support is needed for governments to act. The purpose of this qualitative collective case study was to examine if community engagement in the Local Environment Action on Food (LEAF) project, a community-based food environment intervention in Alberta, Canada, could build public support and create action to promote healthy food environments. Semi-structured interviews with a purposeful sample of 26 stakeholders from 7 communities explored LEAF’s impact and stakeholder experiences creating change. Data collection and analysis were iterative, following Charmaz’s constant comparative analysis strategy. Participants reported environmental and community impacts from LEAF. Notably, LEAF created a context-specific tool, a Mini Nutrition Report Card, that communities used to promote and support food environment action. Further, analysis outlined perceived barriers and facilitators to creating community-level food environment action, including level of engagement in LEAF, perceived controllability, community priorities, policy enforcement and resources. Findings from this study suggest that community-based interventions, such as LEAF, can help build community capacity and reduce existing barriers to community-level food environment action. Thus, they can provide an effective method to build public awareness, demand and action for healthier food environments.
Pulmonary valve prostheses: patient’s lifetime procedure load and durability. Evaluation of the German National Register for Congenital Heart Defects
Authors: Boethig Dietmar , Avsar Murat , Bauer Ulrike M M , Sarikouch Samir , Beerbaum Philipp , Berger Felix , Cesnjevar Robert , Dähnert Ingo , Dittrich Sven , Ewert Peter , Haverich Axel , Hörer Jürgen , Kostelka Martin , Photiadis Joachim , Sandica Eugen , Schubert Stephan , Urban Aleksandra , Bobylev Dmitry , Horke Alexander ,   National Register For Congenital Heart Defects Investigators
Published: July 2021

OBJECTIVES

We evaluated 4384 procedures performed between 1957 and 2018, collected in the National Register for Congenital Heart Defects, conducted on 997 patients with 1823 pulmonary valve replacements (PVRs), including 226 implanted via catheter [transcatheter valve (TCV)]. Main study targets are as follows: TCV benefit, valve type durability, decade-wise treatment changes and procedure frequencies over the lifetime of a PVR patient.

METHODS

We studied TCV impact on surgical valve replacement (via Kaplan–Meier); pulmonary valve type-specific performance (Kaplan–Meier and Cox regressions with age group as stratification or ordinary variable); procedure interval changes over the decades (Kaplan–Meier); procedure load, i.e. frequency of any procedure/surgical PVR/interventional or surgical PVR by patient age (multistate analyses).

RESULTS

TCV performance was equivalent to surgical PVRs and extended durability significantly. Homografts were most durable; Contegras lasted comparably less in older; and Hancock devices lasted less in younger patients. Matrix P-valves showed poorer performance. Age group stratification improves the precision of valve-specific explantation hazard estimations. The current median interval between procedures is 2.6 years; it became significantly shorter in most age groups below 40 years. At 30 years, 80% of patients had undergone ≥3 procedures, 20% ≥3 surgical PVRs and 42% ≥3 surgical or interventional PVRs.

CONCLUSIONS

TCVs doubled freedom from explantation of conventional valves. Homografts’ age group-specific explantation hazard ratio was lowest; Matrix P’s hazard ratio was highest. Age-stratified Cox regressions improve the precision of prosthesis durability evaluations. The median time between procedures for PVR patients shortened significantly to 2.6 years. At 30 years, 42% had ≥3 PVRs.
Research on control strategy of battery-supercapacitor hybrid energy storage system based on droop control
Authors: Chen Min , Zhang Jian
Published: July 2021

The hybrid energy storage system can compensate the bus power fluctuation caused by the output power and load variation of the generator set in the Direct Current (DC) microgrid. In the current control strategy, the voltage droop method is used to control the non-high-frequency components of the battery to suppress the power fluctuation of the bus and the integral droop method is used to control the components of the supercapacitor to suppress the high-frequency power fluctuation. The effect of this strategy is similar to that of a filter, which automatically divides the ripple power into high frequency and non-high-frequency ripple components. However, when the voltage drop method is adopted, the difference of battery State of charge (SOC) in the parallel hybrid energy storage unit is not considered and the non-high-frequency fluctuation components subjected to by the battery are not redistributed, which is not beneficial to the avoidance of battery overcharge and over discharge. It is considered that the voltage drop coefficient will be affected by SOC, the voltage drop coefficient is divided by the n power of SOC to get a new voltage drop coefficient, and then the improved voltage drop method related to the voltage drop coefficient SOC is obtained, and then a new coordinated control strategy is obtained by combining the integral drop method. Simulation and experimental results show that the proposed control strategy can reallocate the non-high-frequency power according to the SOC of the battery and suppress the bus power fluctuation at the same time, so as to realize the SOC balance of different energy storage cells, and the bus voltage fluctuation is small during the whole process.
Vector Bundles with Numerically Flat Reduction on Rigid Analytic Varieties andp-Adic Local Systems
Authors: Würthen Matti
Published: July 2021

We show how to functorially attach continuous $p$-adic representations of the profinite fundamental group to vector bundles with numerically flat reduction on a proper rigid analytic variety over ${{\mathbb {C}}}_p$. This generalizes results by Deninger and Werner for vector bundles on smooth algebraic varieties. Our approach uses fundamental results on the pro-étale site of a rigid analytic variety introduced by Scholze. This enables us to get rid of the smoothness condition and to work in the analytic category. Moreover, under some mild conditions, the functor we construct gives a full embedding of the category of vector bundles with numerically flat reduction into the category of continuous ${{\mathbb {C}}}_p$-representations. This provides new insights into the $p$-adic Simpson correspondence in the case of a vanishing Higgs field.
Severe Acute Respiratory Syndrome Coronavirus 2 Normalized Viral Loads and Subgenomic RNA Detection as Tools for Improving Clinical Decision Making and Work Reincorporation
Authors: Santos Bravo Marta , Nicolás David , Berengua Carla , Fernandez Mariana , Hurtado Juan Carlos , Tortajada Marta , Barroso Sonia , Vilella Anna , Mosquera Maria Mar , Vila Jordi , Marcos María Angeles
Published: July 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse-transcription polymerase chain reaction (RT-PCR) provides a highly variable cycle threshold (Ct) value that cannot distinguish viral infectivity. Subgenomic ribonucleic acid (sgRNA) has been used to monitor active replication. Given the importance of long RT-PCR positivity and the need for work reincorporation and discontinuing isolation, we studied the functionality of normalized viral loads (NVLs) for patient monitoring and sgRNA for viral infectivity detection.

Methods

The NVLs measured through the Nucleocapsid and RNA-dependent-RNA-polymerase genes and sgRNA RT-PCRs were performed in 2 consecutive swabs from 84 healthcare workers.

Results

The NVLs provided similar and accurate quantities of both genes of SARS-CoV-2 at 2 different timepoints of infection, overcoming Ct-value and swab collection variability. Among SARS-CoV-2-positive samples, 51.19% were sgRNA-positive in the 1st RT-PCR and 5.95% in the 2nd RT-PCR. All sgRNA-positive samples had >4 log10 RNA copies/1000 cells, whereas samples with ≤1 log10 NVLs were sgRNA-negative. Although NVLs were positive until 29 days after symptom onset, 84.1% of sgRNA-positive samples were from the first 7 days, which correlated with viral culture viability. Multivariate analyses showed that sgRNA, NVLs, and days of symptoms were significantly associated (P < .001).

Conclusions

The NVLs and sgRNA are 2 rapid accessible techniques that could be easily implemented in routine hospital practice providing a useful proxy for viral infectivity and

coronavirus disease 2019 patient follow-up.
Provider experience and satisfaction with a novel ‘virtual team rounding’ program during the COVID-19 pandemic
Authors: Becker Nora V , Mendu Mallika L , Martin Kate L , Hirner Jesse P , Bakshi Salina , Carlile Narath
Published: July 2021

Background

New inpatient virtual care models have proliferated in response to the challenges presented by the coronavirus disease 2019 (COVID-19) pandemic; however, few of these programs have yet been evaluated for acceptability and feasibility.

Objective

Assess feasibility and provider experience with the Virtual Team Rounding Program (VTRP), a quality improvement project developed and rapidly scaled at Brigham and Women’s Hospital in Boston, MA, in response to the surge of COVID-19 patients in the spring of 2020.

Methods

We surveyed 777 inpatient providers and 41 providers who served as ‘virtual rounders’ regarding their experience with the program. Inpatient providers were asked about their overall satisfaction with the program, whether the program saved them time, and if so, how much and their interest in working with a similar program in the future. Providers who had worked as virtual rounders were asked about their overall satisfaction with the program, the overall difficulty of the work and their interest in participating in a similar program in the future.

Results

We find that among both groups the program was well-received, with 72.5% of inpatient providers and 85.7% of virtual rounders reporting that they were ‘satisfied’ or ‘very satisfied’ with their experience with the program. Among inpatient providers who worked with the program, two-thirds reported the program saved them time on a daily basis. Inpatient respondents who had worked with virtual rounders were more likely to say that they would be interested in working with the VTRP in the future compared with respondents who never worked with a virtual rounder (75.3 vs 52.5%, P < 0.001)

Conclusion

As the pandemic continues, rapidly implementing and studying virtual care delivery programs is crucial for hospitals and health systems. We demonstrate the feasibility and acceptability of a ‘virtual rounding’ program assisting inpatient providers. Future work should examine the impact of these programs on patient outcomes.
Effects of serine palmitoyltransferase inhibition by myriocin in ad libitum-fed and nutrient-restricted ewes
Authors: Davis Amanda N , Myers William A , Eduardo Rico Jorge , Feng Wang Lin , Chang Crystal , Richards Andrew T , Moniruzzaman Mohammed , Haughey Norman J , McFadden Joseph W
Published: July 2021

The fungal isolate myriocin inhibits serine palmitoyltransferase and de novo ceramide synthesis in rodents; however, the effects of myriocin on ceramide concentrations and metabolism have not been previously investigated in ruminants. In our study, 12 non-lactating crossbred ewes received an intravenous bolus of myriocin (0, 0.1, 0.3, or 1.0 mg/kg/body weight [BW]; CON, LOW, MOD, or HIGH) every 48 h for 17 d. Ewes consumed a high-energy diet from day 1 to 14 and were nutrient-restricted (straw only) from day 15 to 17. Blood was collected preprandial and at 1, 6, and 12 h relative to bolus and nutrient restriction. Tissues were collected following euthanasia on day 17. Plasma was analyzed for free fatty acids (FFAs), glucose, and insulin. Plasma and tissue ceramides were quantified using mass spectrometry. HIGH selectively decreased metabolizable energy intake, BW, and plasma insulin, and increased plasma FFA (Dose, P < 0.05). Myriocin linearly decreased plasma very-long-chain (VLC) ceramide and dihydroceramide (DHCer) by day 13 (Linear, P < 0.05). During nutrient restriction, fold-change in FFA was lower with increasing dose (P < 0.05). Nutrient restriction increased plasma C16:0-Cer, an effect suppressed by MOD and HIGH (Dose × Time, P < 0.05). Myriocin linearly decreased most ceramide and DHCer species in the liver and omental and mesenteric adipose, VLC ceramide and DHCer in the pancreas, and C18:0-Cer in skeletal muscle and subcutaneous adipose tissue (Linear, P ≤ 0.05). We conclude that the intravenous delivery of 0.3 mg of myriocin/kg of BW/48 h decreases circulating and tissue ceramide without modifying energy intake in ruminants.
Distribution pattern in Aegla uruguayana Schmitt, 1942 (Decapoda: Anomura: Aeglidae): temporal and spatial approach
Authors: Diawol Valeria P , Musin Gabriela E , Collins Pablo A , Giri Federico
Published: July 2021

The presence, density, and distribution pattern of a species in a particular space and time result from evolutionary and ecological processes. We evaluated the density and spatial distribution pattern of the freshwater anomuran crab, Aegla uruguayanaSchmitt, 1942, in relation to temporal and spatial scales. The temporal scale followed a seasonal analysis, and the space scale was evaluated from the study of three streams located in different provinces of Argentina. Specimens were collected in four sampling campaigns during spring, summer, autumn, and winter in three temperate freshwater environments of the La Plata Basin, Argentina, using 1 m2 sampling units. The density varied according to the studied populations and was not by seasonality. The distribution pattern was not influenced by the evaluated scales. The A. uruguayana populations presented a clumped pattern showing a negative binomial distribution. A possible cause of such a pattern is the strong environmental heterogeneity of the three studied sites. The species presented gregarious behavior that could be associated with the spatial arrangement of the shelters available in the particular habitats as well as ecological strategies for optimal and efficient use of resources in these topographies. Our study is the first on the dynamics of the distribution in terms of temporal and spatial scopes of a species of AeglaLeach, 1820, an endemic freshwater anomuran.
Effects of psoas major muscle volume in predicting the prognosis of patients with upper urinary tract urothelial carcinoma treated with radical nephroureterectomy
Authors: Yuzuriha Soichiro , Hasegawa Masanori , Nakajima Nobuyuki , Shimizu Yuki , Otaki Tatsuya , Umemoto Tatsuya , Kawakami Masayoshi , Kim Hakushi , Nitta Masahiro , Kawamura Yoshiaki , Shoji Sunao , Miyajima Akira
Published: July 2021

Background

This study evaluated the impact of sarcopenia and psoas major muscle volume on the survival of patients with upper urinary tract urothelial carcinoma who had undergone radical nephroureterectomy.

Methods

We reviewed data from 110 patients treated with radical nephroureterectomy in our department between June 2007 and February 2017. Psoas major muscle volume was quantified based on computed tomography data using Synapse Vincent software. The psoas major muscle volume index was calculated as psoas major muscle volume/height squared (cm3/m2). We analysed relapse-free survival, cancer-specific survival and overall survival after radical nephroureterectomy to identify factors that predicted patient survival.

Results

The median psoas major muscle volume index was 121.5 cm3/m2, and the psoas major muscle volume index was <100 cm3/m2 in 34 of 110 patients (30.9%). Multivariate analysis indicated that ≥pT3-stage cancer, lymphovascular invasion and a psoas major muscle volume index of <100 cm3/m2 were independent predictors of shorter relapse-free survival, cancer-specific survival and overall survival. Using these factors, patients were stratified into three groups: low, intermediate and high risks for relapse-free survival, cancer-specific survival and overall survival.

Conclusions

Low psoas major muscle volume resulting from sarcopenia, high T stage and the presence of lymphovascular invasion was associated with poor survival in patients with urinary tract urothelial carcinoma who had undergone radical nephroureterectomy, supporting the use of psoas major muscle volume as a new objective prognostic marker.
A Comparative Study of Likelihood Approximations for Univariate Diffusions
Authors: Hurn Stan , Lindsay Kenneth , Xu Lina
Published: July 2021

Maximum likelihood estimation of the parameters of stochastic differential equations commonly used in finance requires numerical approximation of their transitional probability density functions. This article undertakes a comparative study of the accuracy of Hermite polynomial expansion approximations for univariate diffusions and checks how the accuracy of the existing methods responds to increasing the order of the approximation. It is found that one class of expansion dealing with irreducible diffusions is particularly problematic due to the need to evaluate a number of troublesome integrals. A Gaussian quadrature is introduced which resolves the problem and improves the reliability of the expansion. A simulation study demonstrates all the methods in action and provides insight into the practical aspects of using these expansions. An empirical application using data on the VIX indicates that the proposed method based on the Gaussian quadrature performs very well when applied to financial data.
The wheat SHORT ROOT LENGTH 1 gene TaSRL1 controls root length in an auxin-dependent pathway
Authors: Zhuang Mengjia , Li Chaonan , Wang Jingyi , Mao Xinguo , Li Long , Yin Jun , Du Yan , Wang Xiang , Jing Ruilian
Published: July 2021

The root is the main organ for water and nutrient uptake and sensing environmental stimuli in the soil. The optimization of root system architecture contributes to stress tolerance and yield improvement. ERF (ETHYLENE RESPONSIVE FACTOR) is one of the plant-specific transcription factor families associated with various developmental processes and stress tolerance. We cloned a novel ERF transcription factor gene TaSRL1 (SHORT ROOT LENGTH 1) from wheat (Triticum aestivum) which is mainly expressed in root. Ectopic expression of TaSRL1 in rice resulted in short root length and plant height. TaSRL1 regulated expression of genes related to auxin synthesis, transport, and signaling. Further studies revealed that TaSRL1 induced expression of the auxin transport gene TaPIN2 by directly binding to its promoter, while the interaction of TaSRL1 and TaTIFY9 repressed TaPIN2 expression. Sequence polymorphisms and association analysis showed that TaSRL1-4A was associated with root depth and angle, plant height, and 1000-grain weight of wheat. The haplotype Hap-4A-2 with shallow roots, short plant height, and high 1000-grain weight has been positively selected in the Chinese wheat breeding process. We demonstrated that TaSRL1 functions as a direct regulator of TaPIN2 in the auxin-dependent pathway, and integrates auxin and jasmonate signaling by interacting with TaTIFY9 to repress root growth. Furthermore, the molecular marker of TaSRL1-4A is valuable for the improvement of the root system, plant architecture, and yield in the wheat breeding process.
The Chicken Pan-Genome Reveals Gene Content Variation and a Promoter Region Deletion in IGF2BP1 Affecting Body Size
Authors: Wang Kejun , Hu Haifei , Tian Yadong , Li Jingyi , Scheben Armin , Zhang Chenxi , Li Yiyi , Wu Junfeng , Yang Lan , Fan Xuewei , Sun Guirong , Li Donghua , Zhang Yanhua , Han Ruili , Jiang Ruirui , Huang Hetian , Yan Fengbin , Wang Yanbin , Li Zhuanjian , Li Guoxi , Liu Xiaojun , Li Wenting , Edwards David , Kang Xiangtao
Published: July 2021

Domestication and breeding have reshaped the genomic architecture of chicken, but the retention and loss of genomic elements during these evolutionary processes remain unclear. We present the first chicken pan-genome constructed using 664 individuals, which identified an additional approximately 66.5-Mb sequences that are absent from the reference genome (GRCg6a). The constructed pan-genome encoded 20,491 predicated protein-coding genes, of which higher expression levels are observed in conserved genes relative to dispensable genes. Presence/absence variation (PAV) analyses demonstrated that gene PAV in chicken was shaped by selection, genetic drift, and hybridization. PAV-based genome-wide association studies identified numerous candidate mutations related to growth, carcass composition, meat quality, or physiological traits. Among them, a deletion in the promoter region of IGF2BP1 affecting chicken body size is reported, which is supported by functional studies and extra samples. This is the first time to report the causal variant of chicken body size quantitative trait locus located at chromosome 27 which was repeatedly reported. Therefore, the chicken pan-genome is a useful resource for biological discovery and breeding. It improves our understanding of chicken genome diversity and provides materials to unveil the evolution history of chicken domestication.
Cancer cells are highly susceptible to accumulation of templated insertions linked to MMBIR
Authors: Osia Beth , Alsulaiman Thamer , Jackson Tyler , Kramara Juraj , Oliveira Suely , Malkova Anna
Published: July 2021

Microhomology-mediated break-induced replication (MMBIR) is a DNA repair pathway initiated by polymerase template switching at microhomology, which can produce templated insertions that initiate chromosomal rearrangements leading to neurological and metabolic diseases, and promote complex genomic rearrangements (CGRs) found in cancer. Yet, how often templated insertions accumulate from processes like MMBIR in genomes is poorly understood due to difficulty in directly identifying these events by whole genome sequencing (WGS). Here, by using our newly developed MMBSearch software, we directly detect such templated insertions (MMB-TIs) in human genomes and report substantial differences in frequency and complexity of MMB-TI events between normal and cancer cells. Through analysis of 71 cancer genomes from The Cancer Genome Atlas (TCGA), we observed that MMB-TIs readily accumulate de novo across several cancer types, with particularly high accumulation in some breast and lung cancers. By contrast, MMB-TIs appear only as germline variants in normal human fibroblast cells, and do not accumulate as de novo somatic mutations. Finally, we performed WGS on a lung adenocarcinoma patient case and confirmed MMB-TI-initiated chromosome fusions that disrupted potential tumor suppressors and induced chromothripsis-like CGRs. Based on our findings we propose that MMB-TIs represent a trigger for widespread genomic instability and tumor evolution.
Single molecule/particle tracking analysis program SMTracker 2.0 reveals different dynamics of proteins within the RNA degradosome complex inBacillus subtilis
Authors: Oviedo-Bocanegra Luis M , Hinrichs Rebecca , Rotter Daniel Andreas Orlando , Dersch Simon , Graumann Peter L
Published: July 2021

Single-molecule (particle) tracking is a powerful method to study dynamic processes in cells at highest possible spatial and temporal resolution. We have developed SMTracker, a graphical user interface for automatic quantifying, visualizing and managing of data. Version 2.0 determines distributions of positional displacements in x- and y-direction using multi-state diffusion models, discriminates between Brownian, sub- or superdiffusive behaviour, and locates slow or fast diffusing populations in a standardized cell. Using SMTracker, we show that the Bacillus subtilis RNA degradosome consists of a highly dynamic complex of RNase Y and binding partners. We found similar changes in molecule dynamics for RNase Y, CshA, PNPase and enolase, but not for phosphofructokinase, RNase J1 and J2, to inhibition of transcription. However, the absence of PfkA or of RNase J2 affected molecule dynamics of RNase Y-mVenus, indicating that these two proteins are indeed part of the degradosome. Molecule counting suggests that RNase Y is present as a dimer in cells, at an average copy number of about 500, of which 46% are present in a slow-diffusive state and thus likely engaged within degradosomes. Thus, RNase Y, CshA, PNPase and enolase likely play central roles, and RNase J1, J2 and PfkA more peripheral roles, in degradosome architecture.
T-CoV: a comprehensive portal of HLA-peptide interactions affected by SARS-CoV-2 mutations
Authors: Nersisyan Stepan , Zhiyanov Anton , Shkurnikov Maxim , Tonevitsky Alexander
Published: July 2021

Rapidly appearing SARS-CoV-2 mutations can affect T cell epitopes, which can help the virus to evade either CD8 or CD4 T-cell responses. We developed T-cell COVID-19 Atlas (T-CoV, https://t-cov.hse.ru) – the comprehensive web portal, which allows one to analyze how SARS-CoV-2 mutations alter the presentation of viral peptides by HLA molecules. The data are presented for common virus variants and the most frequent HLA class I and class II alleles. Binding affinities of HLA molecules and viral peptides were assessed with accurate in silico methods. The obtained results highlight the importance of taking HLA alleles diversity into account: mutation-mediated alterations in HLA-peptide interactions were highly dependent on HLA alleles. For example, we found that the essential number of peptides tightly bound to HLA-B*07:02 in the reference Wuhan variant ceased to be tight binders for the Indian (Delta) and the UK (Alpha) variants. In summary, we believe that T-CoV will help researchers and clinicians to predict the susceptibility of individuals with different HLA genotypes to infection with variants of SARS-CoV-2 and/or forecast its severity.
New-onset hypogammaglobulinaemia and infectious complications associated with rituximab use in childhood-onset rheumatic diseases
Authors: Ong Mei Sing , Rothman Deborah , Barmettler Sara , Son Mary Beth , Lo Mindy , Roberts Jordan , Natter Marc
Published: July 2021

Objective

To investigate the incidence and risk factors for hypogammaglobulinaemia and infectious complications associated with rituximab treatment in childhood-onset rheumatic diseases.

Methods

We performed a single-centre retrospective study of patients (n = 85) treated at Boston Children’s Hospital (BCH) from 2009 to 2019. Study subjects included patients (ages 6–24 years) who received rituximab for the treatment of a childhood-onset rheumatic disease.

Results

New-onset hypogammaglobulinaemia developed in 23 (27.1%) patients within 18 months of rituximab induction treatment. Twenty-two patients (25.9%) developed at least one infectious complication in the 18 months following the first rituximab infusion; of these, 11 (50%) had serious infections requiring inpatient treatment. After adjusting for potential confounders, exposure to pulse corticosteroid therapy in the month prior to rituximab use was a significant predictor of both new-onset hypogammaglobulinaemia (odds ratio [OR] 3.94; 95% CI: 1.07, 16.0; P = 0.044) and infectious complications (OR 15.3; 95% CI: 3.04, 126.8; P = 0.003). Post-rituximab hypogammaglobulinaemia was the strongest predictor of serious infectious complications (OR 7.89; 95% CI: 1.41, 65.6; P = 0.028). Younger age at rituximab use was also a significant predictor of new-onset hypogammaglobulinaemia (OR 0.83; 95% CI: 0.70, 0.97; P = 0.021). Compared with other rheumatic diseases, patients with vasculitis had a higher likelihood of developing infectious complications, including serious infections.

Conclusion

Although rituximab was well tolerated in terms of infectious complications in the majority of patients with childhood-onset rheumatic diseases, a substantial proportion developed new-onset hypogammaglobulinaemia and infectious complications following treatment. Our study highlights a role for heightened vigilance of rituximab-associated hypogammaglobulinaemia and infections in paediatric patients with rheumatic conditions.
The Influencing Factors of Sleep Quality Among Chinese Junior and Senior High School Adolescents During the COVID-19 Pandemic
Authors: Zhai Xiaobing , Zeng Jing , Eshak Ehab S , Zhang Yanan , Yang Mei , Di Lihua , Xiang Bing , Cao Jinhong
Published: July 2021

Background

Since coronavirus disease 2019 (COVID-19) outbreak, its terrible infectiousness has caused great panic, anxiety and poor sleep quality to the vulnerable adolescent populations.

Methods

This cross-sectional online survey recruited 10 569 Chinese junior and senior high school adolescents during 31 January to 9 February 2020. Basic socio-demographic information, Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS) and Fear of negative evaluation (FNE) were included in the survey. The χ2 and logistic regression analyses were used to identify factors correlated with poor sleep quality.

Results

The prevalence of poor sleep quality was 18.6% in the Chinese adolescent population. The average score of PSQI was 3.39 (SD = 2.64), which was significantly correlated with scores for anxiety (r = 0.50, p < 0.01), and FNE (r = 0.36, p < 0.01). Adjusted logistic regression indicated that gender (females) and education (senior high school) were associated with poor sleep quality, while living in Hubei Province and time spent on the COVID-19 information were inversely associated with poor sleep quality. Having a family member or friend infected/suspected and spending time on electronics were associated with higher odds of having poor sleep quality. Adolescents with anxiety were 8 times, and those with FNE were three times more likely than ones without anxiety or FNE to have poor sleep quality. In addition, the number of meals, exercise time and diet quality were also significantly associated with sleep quality. (p < 0.05).

Conclusions

Poor sleep quality was common during the COVID-19 pandemic in Chinese adolescents. Understanding several factors associated with the poor sleep quality will offer some important insights into determining potential interventions to improve sleep quality during the COVID-19 pandemic.
Prophylactic Application of Tailocins Prevents Infection by Pseudomonas syringae
Authors: Baltrus David A. , Clark Meara , Hockett Kevin L. , Mollico Madison , Smith Caitlin , Weaver Savannah
Published: July 2021

Tailocins are phage-derived bacteriocins that demonstrate great potential as agricultural antimicrobials given their high killing efficiency and their precise strain-specific targeting ability. Our group has categorized and characterized tailocins produced by and tailocin sensitivities of the phytopathogen Pseudomonas syringae, and here we extend these experiments to test whether prophylactic tailocin application can prevent infection of Nicotiana benthamiana by P. syringae pv. syringae B728a. Specifically, we demonstrate that multiple strains can produce tailocins that prevent infection by strain B728a and engineer a deletion mutant to prove that tailocin targeting is responsible for this protective effect. Lastly, we provide evidence that heritable resistance mutations do not explain the minority of cases in which tailocins fail to prevent infection. Our results extend previous reports of prophylactic use of tailocins against phytopathogens, and establish a model system with which to test and optimize tailocin application for prophylactic treatment to prevent phytopathogen infection.
Preparing Future Doctors for Telemedicine: An Asynchronous Curriculum for Medical Students Implemented During the COVID-19 Pandemic
Authors: Frankl Susan E. , Joshi Ashwini , Onorato Sarah , Jawahir Gilianne L. , Pelletier Stephen R. , Dalrymple John L. , Schwartz Andrea W.
Published: July 2021

Problem

The COVID-19 pandemic led to changes in both the clinical environment and medical education. The abrupt shift to telemedicine in March 2020, coupled with the recommendation that medical students pause in-person clinical rotations, highlighted the need for student training in telemedicine.

Approach

To maintain students’ ability to participate in clinical encounters and continue learning in the new virtual environment, a telemedicine curriculum for clinical students was rapidly developed at Harvard Medical School (HMS) focusing on the knowledge and skills needed to conduct live video encounters. Curriculum leads created an interactive, flexible curriculum to teach students clinical skills, regulatory issues, professionalism, and innovations in telemedicine. This 5-module curriculum was delivered using various primarily asynchronous modalities including webinar-style presentations, prerecorded videos of physical exams from different disciplines, shadowing a synchronous telemedicine visit, peer discussions in small groups, and quizzes with both multiple-choice and open-ended questions.

Outcomes

During May 2020, 252 clerkship and postclerkship medical students at HMS completed the telemedicine curriculum. All students completed a precourse survey and 216 (85.7%) completed the postcourse survey. Students’ self-rated knowledge of telemedicine increased, on average, from 38 (15.1%) reporting being fairly/very knowledgeable over 4 domains before the course to 182 (84.3%) afterward (P < .001). The course was highly rated, with 176/205 (85.9%) students reporting that it met their learning needs and 167/205 (81.5%) finding the delivery methods to be effective. Of 101 (45.3%) students who answered an open-ended postcourse survey question, 91 (90.1%) reported asynchronous learning to be a positive experience.

Next Steps

As telemedicine becomes increasingly and likely permanently integrated into the health care system, providing medical students with robust training in conducting care virtually will be essential. This curriculum provides a promising and feasible framework upon which other schools can apply these emerging competencies to design their own telemedicine curricula.
High turnover for ambulatory orthopedic surgery
Authors: Shariat Ali , Marcus Berend , Latmore Malikah
Published: July 2021

Purpose of review

The trend in the perioperative management of patients having orthopedic surgery in the ambulatory setting emphasizes time-efficiency and rapid turnovers. Anesthetic techniques and management continue to evolve to increase efficiency and decrease time spent in recovery.

Recent findings

Minimizing time patients spend in phase 1 recovery or bypassing phase 1 altogether, known as fast-tracking, has become an important goal in containing costs in high turnover, ambulatory settings. Anesthetic techniques, particularly implementation of regional anesthesia and multimodal analgesia, have evolved to maximize efficiency.

Anesthetic goals in the setting of high-turnover orthopedic surgery include effective multimodal analgesia, decreasing monotherapy with opioids, and patient education. Regional anesthesia as part of a multimodal analgesic regimen is increasingly used in ambulatory surgery fast-tracking protocols.
Propensity-matched Analysis of 1062 Patients Following Minimally Invasive Versus Open Sacroiliac Joint Fusion
Authors: Ballatori Alexander M. , Shahrestani Shane , Chen Xiao T. , Ton Andy , Wang Jeffrey C. , Buser Zorica
Published: July 2021

Study Design:

This was a retrospective cohort study.

Objective:

The aim of this study was to compare the hospital charges and postoperative complications of minimally invasive surgery (MIS) and open approaches to sacroiliac joint (SIJ) fusion.

Summary of Background Data:

The data source utilized in this study is the Healthcare Cost and Utilization Project National Readmission Database (NRD) from 2016 and 2017. The NRD is a yearly nationally representative inpatient database from the Agency for Healthcare Research and Quality with information regarding patient demographics, diagnoses, procedures, and readmissions.

Materials and Methods:

The 2016−2017 NRD was used to identify 2521 patients receiving SIJ fusion with open (n=1990) or MIS approaches (n=531) for diagnosed sacrum pain, sacroiliitis, sacral instability, or spondylosis after excluding for those who received prior SIJ fusion, those diagnosed with neoplasms or trauma of the pelvis or sacrum, and nonelective procedures. We then one-to-one propensity-matched the open (n=531) to the MIS approach (n=531) for age, sex, and Charlson Comorbidity Index. Statistical analysis was performed to compare total hospital charges, immediate surgical complications, nonelective readmission rate, and 30-, 90-, and 180-day postoperative complications between the 2 approaches.

Results:

The mean total hospital charge was the only significant difference between 2 group. Open SIJ fusion had significantly higher charge compared with the MIS approach (open $101,061.90±$81,136.67; MIS $83,594.78±$49,086.00, P<0.0001). The open approach was associated with nonsignificant higher rates of novel lumbar pathology at 30-, 90-, and 180-day readmissions and revision surgeries at 30 and 180 days. MIS approach had higher rates nervous system complications at 30-, 90-, and 180-day readmission, as well as infection and urinary tract infection within 30 days, none being significant. Novel postprocedural pain was similar between the 2 groups at 90 and 180 days.

Conclusions:

The current study found that open SIJ fusion was associated with significantly higher hospital charges. Although no significant differences in postoperative complications were found, there were several notable trends specific to each surgical approach.
Defining Familial Interactions and Networks: An Exploratory Qualitative Study on Family Networks and Surrogate Decision-Making
Authors: Harvey Sarah V. , Adenwala Adam Y. , Lane-Fall Meghan B.
Published: July 2021

OBJECTIVES:

To characterize patient preferences for medical surrogate decision-makers in the ICU to capture the complexity of decision-making preferences and highlight potential conflicts between patients’ preferences and clinicians’ surrogate decision-maker identification in usual clinical practice.

DESIGN:

Prospective qualitative cross-sectional study.

SETTING:

Two ICUs in a quaternary referral center in the eastern United States.

PATIENTS:

Convenience sample of patients admitted to the ICU and their family members.

INTERVENTION:

None.

MEASUREMENTS AND MAIN RESULTS:

Twenty-six patient-family-clinician units were interviewed. Men were three times more likely than women to have a legally appointed decision-maker that matched their preferred decision-maker as expressed in the interview. Patients who were married or in a long-term relationship were the most consistent group of respondents, with 94% of them selecting their spouse or partner as the preferred decision-maker. The most common reasons for selecting a surrogate decision-maker were intangible themes such as feeling “known” by that person rather than having prior discussions about specific wishes or advance directives.

CONCLUSIONS:

Asking about a patient’s familial network and qualities they value in a surrogate decision-maker may aid ICU teams in honoring patients’ wishes for surrogate decision-making. This may be an important supplement to accepted legal hierarchies for proxy decision-makers and advance directive documents. Further studies with larger sample sizes could be used to shed light on the nuances of familial and relationship networks of a more diverse population of respondents.
Cardiac Output Measurement in Neonates and Children Using Noninvasive Electrical Bioimpedance Compared With Standard Methods: A Systematic Review and Meta-Analysis*
Authors: Mansfield Roshni C. , Kaza Nandita , Charalambous Anna , Milne Andrew C. , Sathiyamurthy Sundar , Banerjee Jayanta
Published: July 2021

Objective:

To systematically review and meta-analyze the validity of electrical bioimpedance-based noninvasive cardiac output monitoring in pediatrics compared with standard methods such as thermodilution and echocardiography.

Data Sources:

Systematic searches were conducted in MEDLINE and EMBASE (2000–2019).

Study Selection:

Method-comparison studies of transthoracic electrical velocimetry or whole body electrical bioimpedance versus standard cardiac output monitoring methods in children (0–18 yr old) were included.

Data Extraction:

Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Mean differences of cardiac output, stroke volume, or cardiac index measurements were pooled using a random-effects model (R Core Team, R Foundation for Statistical Computing, Vienna, Austria, 2019). Bland-Altman statistics assessing agreement between devices and author conclusions about inferiority/noninferiority were extracted.

Data Synthesis:

Twenty-nine of 649 identified studies were included in the qualitative analysis, and 25 studies in the meta-analyses. No significant difference was found between means of cardiac output, stroke volume, and cardiac index measurements, except in exclusively neonatal/infant studies reporting stroke volume (mean difference, 1.00 mL; 95% CI, 0.23–1.77). Median percentage error in child/adolescent studies approached acceptability (percentage error less than or equal to 30%) for cardiac output in L/min (31%; range, 13–158%) and stroke volume in mL (26%; range, 14–27%), but not in neonatal/infant studies (45%; range, 29–53% and 45%; range, 28–70%, respectively). Twenty of 29 studies concluded that transthoracic electrical velocimetry/whole body electrical bioimpedance was noninferior. Transthoracic electrical velocimetry was considered inferior in six of nine studies with heterogeneous congenital heart disease populations.

Conclusions:

The meta-analyses demonstrated no significant difference between means of compared devices (except in neonatal stroke volume studies). The wide range of percentage error reported may be due to heterogeneity of study designs, devices, and populations included. Transthoracic electrical velocimetry/whole body electrical bioimpedance may be acceptable for use in child/adolescent populations, but validity in neonates and congenital heart disease patients remains uncertain. Larger studies in specific clinical contexts with standardized methodologies are required.
Disease-Modifying Treatments for Transthyretin Amyloidosis
Authors: Tushak Zackary J. , Cox Stephen Zach , Cei Laura F. , Gwathmey Kelly G. , Shah Keyur B.
Published: July 2021

The transthyretin (TTR) amyloidoses result from misfolding of the protein leading to fibril formation and aggregation as amyloid deposits in predominantly the cardiovascular and nervous systems. Cardiac involvement can manifest as heart failure, arrhythmias, and valvular disease. Neurologic involvement can cause sensorimotor polyneuropathies, mononeuropathies, and dysautonomia. Previously, treatment has focused on management of these symptoms and disease sequelae, with a high rate of mortality due to the absence of disease-modifying therapies. In this article, we review novel treatments focusing on 3 mechanistic pathways: (1) silencing of the TTR gene to suppress production, (2) stabilizing of TTR tetramers to prevent misfolding, or (3) disrupting of existing TTR amyloid fibrils to promote reabsorption.
How It Started, and How It’s Going: Global Family Planning Programs
Authors: JOHNSON SARAH A. , KAGGWA MILLY N. , LATHROP EVA
Published: July 2021

Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.