bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of Co(OH)2/CNTs nanocomposite with superior rate capability and cyclic stability for energy storage applications
Authors: Shakir Imran , Almutairi Zeyad , Shar Sahar Saad , Nafady Ayman
Published: October 2020

The good rate capability and longer cyclic performance are the two key features electrochemical capacitors that are highly dependent on the electrochemical stability, structure, electrical conductivity, composition, and nature of the charge storing-mechanism involved by its electrodes. Herein, we fabricated layered Co(OH)2 and their nanocomposite with carbon nanotubes (CNTs, 5%) via a two-step approach for electrochemical applications. The as-prepared nanocomposite based electrode displays good specific capacitance (Cs), negligible capacity fade, and promising rate capability on electrochemical tests via a three-electrode configuration. More precisely, the nanocomposite based electrode showed Cs of 802 Fg−1 at 0.5 Ag−1 and loss just 3.8% of its initial capacitance (at 1st cycle) after 5000 cyclic tests. Furthermore, the nanocomposite electrode lost around 14% of its initial capacitance on increasing the current density from 0.5 to 5 Ag−1 that reveals its novel rate capability. The observed superior electrochemical aptitude of the fabricated nanocomposite is credited to the layered nanoarchitecture of the Co(OH)2 and CNTs matrix. The CNTs-matrix, because of their lower properties, performs multiple roles to improve the supercapacitive performance of the whole composite. Firstly, they accelerate the charge transfer within the nanocomposite matrix due to its higher electrical conductivity. Secondly, they facilitate mass transport due to its hollow structure. Thirdly, they sandwich between the layers of Co(OH)2 and suppress the stacking process. Fourthly, the added CNTs itself act as a capacitive supplement and further improve the specific capacitance of the nanocomposite. Finally, CNTs buffers the whole nanocomposite against the volume expansion during the continuous cyclic tests. The electrochemical and structural stability of Co(OH)2/CNTs sample was also evaluated by EIS and PXRD characterizations after electrochemical tests. The acquired result showed that fabricated nanocomposite has great potential for advanced energy storage applications.
Crystal surface and reflector optimization for the SiPM-based dual-ended readout TOF-DOI PET detector
Authors: Kang Han Gyu , Yamaya Taiga , Han Young Been , Song Seong Hyun , Ko Guen Bae , Lee Jae Sung , Hong Seong Jong
Published: October 2020

Silicon photomultipliers (SiPMs) are now widely used for positron emission tomography (PET) applications because of their high gain and low noise characteristics. The PET image quality has been improved with the advancement of time-of-flight (TOF) and depth-of-interaction (DOI) measurement techniques. For brain-dedicated PET systems, both TOF and DOI information are beneficial for enhancing the reconstructed PET image quality. In a previous study, we proposed SiPM-based dual-ended readout PET detectors that used a mean time method to achieve coincidence timing resolution (CTR) of 349 ps and DOI resolution of 2.9 mm. However, the coincidence timing resolution (CTR) was worse than 300 ps since the crystal surface and the reflector type were not optimized. This study aimed at investigating the optimal crystal surface treatment and the reflector material to achieve a sub-200 ps CTR and sub-3 mm DOI resolution with a dual-ended readout PET detector using an LYSO crystal (2.9 × 2.9 × 20 mm3). The scintillation light inside the LYSO crystal was read out by two SiPMs using the dual-ended readout method. The CTR and DOI resolution were measured with two different crystal surfaces (polished and saw-cut) and three different reflector material scenarios of ESR without grease (i.e., air coupling), ESR with optical grease and Teflon. We digitized the timing and energy signals by using a V775N TDC module (35 ps bit−1) and V965 QDC module, respectively. The combination of the saw-cut LYSO crystal and the ESR with air coupling resulted in the best CTR (188 ± 32 ps) and DOI resolution (2.9 ± 0.2 mm) with the dual-ended readout configuration. We concluded the dual-ended readout method in combination with the saw-cut crystal and the ESR reflector with air coupling can provide a sub-200 ps CTR and sub-3.0 mm DOI resolution simultaneously.
Measuring protein biomarker concentrations using antibody tagged magnetic nanoparticles
Authors: Gordon-Wylie Scott W , Ness Dylan B , Shi Yipeng , Mirza Sohail K , Paulsen Keith D , Weaver John B
Published: October 2020

Under physiological conditions biomarker concentrations tend to rise and fall over time e.g. for inflammation.Ex vivomeasurements provide a snapshot in time of biomarker concentrations, which is useful, but limited. Approaching real time monitoring of biomarker concentration(s) using a wearable, implantable or injectablein vivosensor is therefore an appealing target. As an early step towards developing anin vivobiomarker sensor, antibody (AB) tagged magnetic nanoparticles (NPs) are used here to demonstrate thein vitromeasurement of ∼ 5 distinct biomarkers with high specificity and sensitivity. In previous work, aptamers were used to target a given biomarkerin vitroand generate magnetic clusters that exhibit a characteristic rotational signature quite different from free NPs. Here the method is expanded to detect a much wider range of biomarkers using polyclonal ABs attached to the surface of the NPs. Commercial ABs exist for a wide range of targets allowing accurate and specific concentration measurements for most significant biomarkers. We show sufficient detection sensitivity, using an in-house spectrometer to measure the rotational signatures of the NPs, to assess physiological concentrations of hormones, cytokines and other signaling molecules. Detection limits for biomarkers drawn mainly from pain and inflammation targets were: 10 pM for mouse Granzyme B (mGZM-B), 40 pM for mouse interferon-gamma (mIFN-γ), 7 pM for mouse interleukin-6 (mIL-6), 40 pM for rat interleukin-6 (rIL-6), 40 pM for mouse vascular endothelial growth factor (mVEGF) and 250 pM for rat calcitonin gene related peptide (rCGRP). Much lower detection limits are certainly possible using improved spectrometers and nanoparticles.
Activities of daily living at hospital admission and estimated survival time of older patients
Authors: Ryg Jesper , Engberg Henriette , Anru Pavithra Laxsen , Pedersen Solvejg Gram Henneberg , Jorgensen Martin Gronbech , Vinding Kirsten Laila , Masud Tahir , Andersen-Ranberg Karen
Published: October 2020

Background

Predicting expected survival time in acutely hospitalised older patients is a clinical challenge.

Objective

To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients.

Methods

A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan–Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year.

Results

In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98).

Conclusions

ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department.
Canada Should Move Toward Adopting Harmonized Evidence-Based OELs to Consistently and Adequately Protect Workers
Authors: Barn Prabjit , Keefe Anya R , Slot Nicole , Jardine Katherine J , Ziembicki Stephanie , Telfer Joanne , Palmer Alison L , Peters Cheryl E
Published: October 2020

Due to the way occupational exposure limits (OELs) are set in Canada, workers across the country are not equally and adequately protected from harmful workplace exposures. This disparity is illustrated in the case of exposure to diesel engine exhaust (DEE). Based on the findings of a recent pan-Canadian and international scan of OELs for DEE, we recommend that Canada overcome these current disparities by moving towards harmonized, evidence-based OELs. To achieve this, Canada should adopt a centralized framework for setting OELs that considers the most recent scientific evidence as well as feasibility of implementation in the Canadian context. We assert that harmonizing OELs across Canada would allow for expertise and resources to be consolidated and is a crucial step to ensuring that all workers are consistently protected from harmful workplace exposures.
Female ornaments: is red skin color attractive to males and related to condition in rhesus macaques?
Authors: Higham James P , Kimock Clare M , Mandalaywala Tara M , Heistermann Michael , Cascio Julie , Petersdorf Megan , Winters Sandra , Allen William L , Dubuc Constance
Published: October 2020

Sexual selection produces extravagant male traits, such as colorful ornaments, via female mate choice. More rarely, in mating systems in which males allocate mating effort between multiple females, female ornaments may evolve via male mate choice. Females of many anthropoid primates exhibit ornaments that indicate intraindividual cyclical fertility, but which have also been proposed to function as interindividual quality signals. Rhesus macaque females are one such species, exhibiting cyclical facial color variation that indicates ovulatory status, but in which the function of interindividual variation is unknown. We collected digital images of the faces of 32 rhesus macaque adult females. We assessed mating rates, and consortship by males, according to female face coloration. We also assessed whether female coloration was linked to physical (skinfold fat, body mass index) or physiological (fecal glucocorticoid metabolite [fGCM], urinary C-peptide concentrations) condition. We found that redder-faced females were mated more frequently, and consorted for longer periods by top-ranked males. Redder females had higher fGCM concentrations, perhaps related to their increased mating activity and consequent energy mobilization, and blood flow. Prior analyses have shown that female facial redness is a heritable trait, and that redder-faced females have higher annual fecundity, while other evidence suggests that color expression is likely to be a signal rather than a cue. Collectively, the available evidence suggests that female coloration has evolved at least in part via male mate choice. Its evolution as a sexually selected ornament attractive to males is probably attributable to the high female reproductive synchrony found in this species.
Atrophy and cognitive profiles in older adults with temporal lobe epilepsy are similar to mild cognitive impairment
Authors: Kaestner Erik , Reyes Anny , Chen Austin , Rao Jun , Macari Anna Christina , Choi Joon Yul , Qiu Deqiang , Hewitt Kelsey , Wang Zhong Irene , Drane Daniel L , Hermann Bruce , Busch Robyn M , Punia Vineet , McDonald Carrie R ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: October 2020

Epilepsy incidence and prevalence peaks in older adults yet systematic studies of brain ageing and cognition in older adults with epilepsy remain limited. Here, we characterize patterns of cortical atrophy and cognitive impairment in 73 older adults with temporal lobe epilepsy (>55 years) and compare these patterns to those observed in 70 healthy controls and 79 patients with amnestic mild cognitive impairment, the prodromal stage of Alzheimer’s disease. Patients with temporal lobe epilepsy were recruited from four tertiary epilepsy surgical centres; amnestic mild cognitive impairment and control subjects were obtained from the Alzheimer’s Disease Neuroimaging Initiative database. Whole brain and region of interest analyses were conducted between patient groups and controls, as well as between temporal lobe epilepsy patients with early-onset (age of onset <50 years) and late-onset (>50 years) seizures. Older adults with temporal lobe epilepsy demonstrated a similar pattern and magnitude of medial temporal lobe atrophy to amnestic mild cognitive impairment. Region of interest analyses revealed pronounced medial temporal lobe thinning in both patient groups in bilateral entorhinal, temporal pole, and fusiform regions (all P < 0.05). Patients with temporal lobe epilepsy demonstrated thinner left entorhinal cortex compared to amnestic mild cognitive impairment (P = 0.02). Patients with late-onset temporal lobe epilepsy had a more consistent pattern of cortical thinning than patients with early-onset epilepsy, demonstrating decreased cortical thickness extending into the bilateral fusiform (both P < 0.01). Both temporal lobe epilepsy and amnestic mild cognitive impairment groups showed significant memory and language impairment relative to healthy control subjects. However, despite similar performances in language and memory encoding, patients with amnestic mild cognitive impairment demonstrated poorer delayed memory performances relative to both early and late-onset temporal lobe epilepsy. Medial temporal lobe atrophy and cognitive impairment overlap between older adults with temporal lobe epilepsy and amnestic mild cognitive impairment highlights the risks of growing old with epilepsy. Concerns regarding accelerated ageing and Alzheimer’s disease co-morbidity in older adults with temporal lobe epilepsy suggests an urgent need for translational research aimed at identifying common mechanisms and/or targeting symptoms shared across a broad neurological disease spectrum.
MicroRNA-mediated vascular intercellular communication is altered in chronic kidney disease
Authors: Zietzer Andreas , Steffen Eva , Niepmann Sven , Düsing Philip , Hosen Mohammed Rabiul , Liu Weiyi , Jamme Paul , Al-Kassou Baravan , Goody Philipp Roger , Zimmer Sebastian , Reiners Katrin S , Pfeifer Alexander , Böhm Michael , Werner Nikos , Nickenig Georg , Jansen Felix
Published: October 2020

Aims

Chronic kidney disease (CKD) is an independent risk factor for the development of coronary artery disease (CAD). For both, CKD and CAD, the intercellular transfer of microRNAs (miRs) through extracellular vesicles (EVs) is an important factor of disease development. Whether the combination of CAD and CKD affects endothelial function through cellular crosstalk of EV-incorporated miRs is still unknown.

Methods and results

Out of 172 screened CAD patients, 31 patients with CAD + CKD were identified and matched with 31 CAD patients without CKD. Additionally, 13 controls without CAD and CKD were included. Large EVs from CAD + CKD patients contained significantly lower levels of the vasculo-protective miR-130a-3p and miR-126-3p compared to CAD patients and controls. Flow cytometric analysis of plasma-derived EVs revealed significantly higher numbers of endothelial cell-derived EVs in CAD and CAD + CKD patients compared to controls. EVs from CAD + CKD patients impaired target human coronary artery endothelial cell (HCAEC) proliferation upon incubation in vitro. Consistent with the clinical data, treatment with the uraemia toxin indoxyl sulfate (IS)-reduced miR-130a-3p levels in HCAEC-derived EVs. EVs from IS-treated donor HCAECs-reduced proliferation and re-endothelialization in EV-recipient cells and induced an anti-angiogenic gene expression profile. In a mouse-experiment, intravenous treatment with EVs from IS-treated endothelial cells significantly impaired endothelial regeneration. On the molecular level, we found that IS leads to an up-regulation of the heterogenous nuclear ribonucleoprotein U (hnRNPU), which retains miR-130a-3p in the cell leading to reduced vesicular miR-130a-3p export and impaired EV-recipient cell proliferation.

Conclusion

Our findings suggest that EV-miR-mediated vascular intercellular communication is altered in patients with CAD and CKD, promoting CKD-induced endothelial dysfunction.
Sex and age-specific differences in wing pointedness and wing length in blackcapsSylvia atricapillamigrating through the southern Baltic coast
Authors: Ożarowska Agnieszka , Zaniewicz Grzegorz , Meissner Włodzimierz
Published: October 2020

The blackcap Sylvia atricapilla shows a complex migratory pattern and is a suitable species for the studies of morphological migratory syndrome, including adaptations of wing shape to different migratory performance. Obligate migrants of this species that breed in northern, central, and Eastern Europe differ by migration distance and some cover shorter distance to the wintering grounds in the southern part of Europe/North Africa or the British Isles, although others migrate to sub-Saharan Africa. Based on ˃40 years of ringing data on blackcaps captured during autumn migration in the Southern Baltic region, we studied age- and sex-related correlations in wing pointedness and wing length of obligate blackcap migrants to understand the differences in migratory behavior of this species. Even though the recoveries of blackcaps were scarce, we reported some evidence that individuals which differ in migration distance differed also in wing length. We found that wing pointedness significantly increased with an increasing wing length of migrating birds, and adults had longer and more pointed wings than juvenile birds. This indicates stronger antipredator adaptation in juvenile blackcaps than selection on flight efficiency, which is particularly important during migration. Moreover, we documented more pronounced differences in wing length between adult and juvenile males and females. Such differences in wing length may enhance a faster speed of adult male blackcaps along the spring migration route and may be adaptive when taking into account climatic effects, which favor earlier arrival from migration to the breeding grounds.
Relative clinical value of coronary computed tomography and stress echocardiography-guided management of stable chest pain patients: a propensity-matched analysis
Authors: Vamvakidou Anastasia , Danylenko Oleksandr , Pradhan Jiwan , Kelshiker Mihir , Jones Timothy , Whiteside David , Sethi Amarjit , Senior Roxy
Published: October 2020

Aims

The European Society of Cardiology recommends coronary computed tomography (CCT) for the assessment of low-risk patients with suspected stable angina. We aimed to assess in a real-life setting the relative clinical value of stress echocardiography (SE)- and CCT-guided management in this population.

Methods and results

Patients with stable chest pain and no prior history of coronary artery disease (CAD) who underwent CCT or SE as the initial investigative strategy were propensity-matched (990 patients each group-age: 59 ± 13.2 years, males: 47.9%) to account for baseline differences in cardiovascular risk factors. Inconclusive tests were 6% vs. 3% (P < 0.005) in CCT vs. SE. Severe (≥70% stenosis) on CCT and inducible ischaemia on SE detected obstructive CAD by invasive coronary angiography in 63% vs. 57% patients (P = 0.33). Over the follow-up period (median 717, interquartile range 93–1069 days) more patients underwent invasive coronary angiography (21.5% vs. 7.3%, P < 0.005), revascularization (7.3% vs. 3.5%, P < 0.005), further functional testing 33.4% vs. 8.7% (P < 0.005), but more patients were prescribed statins 8.8% vs. 3.8% (P < 0.005) in the CCT vs. the SE arm, respectively. Combined all-cause mortality and acute myocardial infarction was low—CCT-2.3% and SE-3.3%—with no significant difference (P = 0.16).

Conclusion

Initial SE-guided management was similar for the detection of obstructive CAD, demonstrated better resource utilization, but was associated with reduced prescription of statins although with no difference in medium-term outcome compared to CCT in this very low-risk population. However, a randomized study with longer follow-up is needed to confirm the clinical value of our findings.
Defining the prognostic value of [15O]H2O positron emission tomography-derived myocardial ischaemic burden
Authors: van Diemen Pepijn A , Wijmenga Jan-Thijs , Driessen Roel S , Bom Michiel J , Schumacher Stefan P , Stuijfzand Wynand J , Everaars Henk , de Winter Ruben W , Raijmakers Pieter G , van de Ven Peter M , van Rossum Albert C , Danad Ibrahim , Knaapen Paul
Published: October 2020

Aims 

Myocardial ischaemic burden (IB) is used for the risk stratification of patients with coronary artery disease (CAD). This study sought to define a prognostic threshold for quantitative [15O]H2O positron emission tomography (PET)-derived IB.

Methods and results 

A total of 623 patients with suspected or known CAD who underwent [15O]H2O PET perfusion imaging were included. The endpoint was a composite of death and non-fatal myocardial infarction (MI). A hyperaemic myocardial blood flow (hMBF) and myocardial flow reserve (MFR)-derived IB were determined. During a median follow-up time of 6.7 years, 62 patients experienced an endpoint. A hMBF IB of 24% and MFR IB of 28% were identified as prognostic thresholds. Patients with a high hMBF or MFR IB (above threshold) had worse outcome compared to patients with a low hMBF IB [annualized event rates (AER): 2.8% vs. 0.6%, P < 0.001] or low MFR IB [AER: 2.4% vs. 0.6%, P < 0.001]. Patients with a concordant high IB had the worst outcome (AER: 3.1%), whereas patients with a concordant low or discordant IB result had similar and low AERs of 0.5% and 0.9% (P = 0.953), respectively. Both thresholds were of prognostic value beyond clinical characteristics, however, only the hMBF IB threshold remained predictive when adjusted for clinical characteristics and combined use of the hMBF and MFR thresholds.

Conclusion 

A hMBF IB ≥24% was a stronger predictor of adverse outcome than an MFR IB ≥28%. Nevertheless, classifying patients according to concordance of IB result allowed for the identification of low- and high-risk patients.
A brief history of ELT Journal
Authors: Smith Richard
Published: October 2020

This article traces the 75-year history of ELT Journal, using this as a means to cast light on trends in ELT over the same period and to acknowledge various sources of thought and practice. In the first part (1946–1971), the focus is on how the journal contributed to the establishment of a methodological orthodoxy which was relatively unaffected by academic applied linguistics but which drew sustenance, rather, from a tradition of theorized experience and practical linguistics dating back to pre-war times. In the second part (1971–1996), the focus is on tensions between this orthodoxy and newer ‘communicative’ ideas—still, though, with an emphasis on practical experience as well as academic insight, while the final phase (1996–2021) is viewed as being characterized, above all, by attempts to ‘decentre’ away from mainly UK-based expertise and towards an opening-up of professional discourse to previously neglected voices. Viewing the history of the journal in this manner reveals continuities as well as shifts in perception of how English should be defined, whose voices ‘count’ in the field, and of the value or otherwise of research and theory in relation to practical concerns.
Conservation analysis of SARS-CoV-2 spike suggests complicated viral adaptation history from bat to human
Authors: Lei Kuan Cheok , Zhang Xiaohua Douglas
Published: October 2020

Background

The current coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome (SARS)-CoV-2, has become the most devastating public health emergency in the 21st century and one of the most influential plagues in history. Studies on the origin of SARS-CoV-2 have generally agreed that the virus probably comes from bat, closely related to a bat CoV named BCoV-RaTG13 taken from horseshoe bat (Rhinolophus affinis), with Malayan pangolin (Manis javanica) being a plausible intermediate host. However, due to the relatively low number of SARS-CoV-2-related strains available in public domain, the evolutionary history remains unclear.

Methodology

Nine hundred ninety-five coronavirus sequences from NCBI Genbank and GISAID were obtained and multiple sequence alignment was carried out to categorize SARS-CoV-2 related groups. Spike sequences were analyzed using similarity analysis and conservation analyses. Mutation analysis was used to identify variations within receptor-binding domain (RBD) in spike for SARS-CoV-2-related strains.

Results

We identified a family of SARS-CoV-2-related strains, including the closest relatives, bat CoV RaTG13 and pangolin CoV strains. Sequence similarity analysis and conservation analysis on spike sequence identified that N-terminal domain, RBD and S2 subunit display different degrees of conservation with several coronavirus strains. Mutation analysis on contact sites in SARS-CoV-2 RBD reveals that human-susceptibility probably emerges in pangolin.

Conclusion and implication

We conclude that the spike sequence of SARS-CoV-2 is the result of multiple recombination events during its transmission from bat to human, and we propose a framework of evolutionary history that resolve the relationship of BCoV-RaTG13 and pangolin coronaviruses with SARS-CoV-2.

Lay Summary

This study analyses whole-genome and spike sequences of coronavirus from NCBI using phylogenetic and conservation analyses to reconstruct the evolutionary history of severe acute respiratory syndrome (SARS)-CoV-2 and proposes an evolutionary history of spike in the progenitors of SARS-CoV-2 from bat to human through mammal hosts before they recombine into the current form.
TheGalleria mellonellainfection model as a system to investigate the virulence ofCandida aurisstrains
Authors: Romera David , Aguilera-Correa John-Jairo , García-Coca Marta , Mahillo-Fernández Ignacio , Viñuela-Sandoval Lourdes , García-Rodríguez Julio , Esteban Jaime
Published: October 2020

Candida auris is a multiresistant pathogenic yeast commonly isolated from bloodstream infections in immunocompromised patients. In this work, we infected Galleria mellonella larvae with 105 CFU of a reference strains and two clinical isolates of C. albicans and C. auris and we compared the outcomes of infection between both species. Larvae were evaluated every 24 h for a total of 120 h following the G. mellonella Health Index Scoring System, and survival, activity, melanization and cocoon formation were monitored. Our results showed that clinical isolates were significantly more pathogenic than reference strains independently of the tested species, producing lower survival and activity scores and higher melanization scores and being C. albicans strains more virulent than C. auris strains. We did not find differences in mortality between aggregative and non-aggregative C. auris strains, although non-aggregative strains produced significantly lower activity scores and higher melanization scores than aggregative ones. Survival assays using Galleria mellonella have been previously employed to examine and classify strains of this and other microbial species based on their virulence before scaling the experiments to a mammal model. Taken together, these results show how a more complete evaluation of the model can improve the study of C. auris isolates.
A historical perspective of MDR invasive pneumococcal disease in Spanish adults
Authors: Càmara Jordi , Grau Inmaculada , González-Díaz Aida , Tubau Fe , Calatayud Laura , Cubero Meritxell , Domínguez M Ángeles , Liñares Josefina , Yuste José , Pallarés Román , Ardanuy Carmen
Published: October 2020

Objectives

To analyse the clonal dynamics and clinical characteristics of adult invasive pneumococcal disease (IPD) caused by MDR and penicillin-non-susceptible (PNS) pneumococci in Spain.

Methods

All adult IPD episodes were prospectively collected (1994–2018). Streptococcus pneumoniae isolates were serotyped, genotyped and tested for antimicrobial susceptibility. Changes in the incidence of IPD were analysed and risk factors contributing to MDR were assessed by logistic regression.

Results

Of 2095 IPD episodes, 635 (30.3%) were caused by MDR/PNS isolates. Over the study period, the incidence of MDR/PNS-IPD decreased (IRR 0.70; 95% CI 0.53–0.93) whereas that of susceptible isolates remained stable (IRR 0.96; 95% CI 0.80–1.16). A reduction of resistance rates to penicillin (–19.5%; 95% CI –37% to 2%) and cefotaxime (–44.5%; 95% CI –64% to –15%) was observed. Two clones, Spain9V-ST156 and Denmark14-ST230, accounted for 50% of current resistant disease. Among current MDR/PNS isolates, 45.8% expressed serotypes not covered by the upcoming PCV15/PCV20 vaccines. MDR/PNS episodes were associated with older patients with comorbidities, nosocomial acquisition and higher 30 day mortality. MDR/PNS pneumococci were not independently associated with 30 day mortality in multivariate analysis [OR 0.826 (0.648–1.054)].

Conclusions

Our study shows an overall reduction of MDR/PNS isolates in adults after the introduction of pneumococcal conjugate vaccines. However, a significant proportion of current resistant isolates are not covered by any of the upcoming PCV15/PCV20 vaccines. The burden of resistant disease is related to older patients with underlying conditions and caused by two major clones. Our data show that MDR is not a statistically significant factor related to increased mortality.
Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study
Authors: Thompson Sarah , Hays Kaitlin , Weintraub Alan , Ketchum Jessica M , Kowalski Robert G
Published: October 2020

Rhythmic auditory stimulation (RAS) has been well researched with stroke survivors and individuals who have Parkinson’s disease, but little research exists on RAS with people who have experienced traumatic brain injury (TBI). This pilot study aimed to (1) assess the feasibility of the study design and (2) explore potential benefits. This single-arm clinical trial included 10 participants who had a 2-week control period between baseline and pretreatment. Participants had RAS daily for a 2-week treatment period and immediately completed post-treatment assessments. Participants then had a 1-week control period and completed follow-up assessment. The starting cadence was evaluated each day of the intervention period due to the variation in daily functioning in this population. All 10 participants were 1–20 years post-TBI with notable deviations in spatial-temporal aspects of gait including decreased velocity, step symmetry, and cadence. All participants had a high risk of falling as defined by achieving less than 22 on the Functional Gait Assessment (FGA). The outcome measures included the 10-m walk test, spatial and temporal gait parameters, FGA, and Physical Activity Enjoyment Scale. There were no adverse events during the study and gait parameters improved. After the intervention, half of the participants achieved a score of more than 22 on the FGA, indicating that they were no longer at high risk of experiencing falls.
Human Muscle Precursor Cells Form Human-Derived Myofibers in Skeletal Muscles of Nonhuman Primates: A Potential New Preclinical Setting to Test Myogenic Cells of Human Origin for Cell Therapy of Myopathies
Authors: Skuk Daniel , Tremblay Jacques P
Published: October 2020

This study aimed to verify if human myogenic cells could participate in muscle regeneration in macaques. This experimental setting would grant researchers a model that could better evaluate the effects of cell therapies in myopathies with a better translation to human patients. Human muscle precursor cells (MPCs) were cultured in vitro and transduced with ß-galactosidase. The cells were subsequently injected into 1-cm3 muscle regions of 6 macaques immunosuppressed with tacrolimus and dexamethasone. Allogeneic ß-galactosidase+ MPCs were injected in other regions as positive controls. Some cell-grafted regions were electroporated to induce extensive muscle regeneration. MPC-grafted regions were sampled 1 month later and analyzed by histology. There were ß-galactosidase+ myofibers in both the regions grafted with human and macaque MPCs. Electroporation increased the engraftment of human MPCs in the same way as in macaque allografts. The histological analysis (hematoxylin and eosin, CD8, and CD4 immunodetection) demonstrated an absence of cellular rejection in most MPC-grafted regions, as well as minimal lymphocytic infiltration in the regions transplanted with human MPCs in the individual with the lowest tacrolimus levels. Circulating de novo anti-donor antibodies were not detected. In conclusion, we report the successful engraftment of human myogenic cells in macaques, which was possible using tacrolimus-based immunosuppression.
Interstitial telomere sequences disrupt break-induced replication and drive formation of ectopic telomeres
Authors: Stivison Elizabeth A , Young Kati J , Symington Lorraine S
Published: October 2020

Break-induced replication (BIR) is a mechanism used to heal one-ended DNA double-strand breaks, such as those formed at collapsed replication forks or eroded telomeres. Instead of utilizing a canonical replication fork, BIR is driven by a migrating D-loop and is associated with a high frequency of mutagenesis. Here we show that when BIR encounters an interstitial telomere sequence (ITS), the machinery frequently terminates, resulting in the formation of an ectopic telomere. The primary mechanism to convert the ITS to a functional telomere is by telomerase-catalyzed addition of telomeric repeats with homology-directed repair serving as a back-up mechanism. Termination of BIR and creation of an ectopic telomere is promoted by Mph1/FANCM helicase, which has the capacity to disassemble D-loops. Other sequences that have the potential to seed new telomeres but lack the unique features of a natural telomere sequence, do not terminate BIR at a significant frequency in wild-type cells. However, these sequences can form ectopic telomeres if BIR is made less processive. Our results support a model in which features of the ITS itself, such as the propensity to form secondary structures and telomeric protein binding, pose a challenge to BIR and increase the vulnerability of the D-loop to dissociation by helicases, thereby promoting ectopic telomere formation.
Kidney transplantation after rescue allocation—meticulous selection yields the chance for excellent outcome
Authors: Assfalg Volker , Misselwitz Svea , Renders Lutz , Hüser Norbert , Novotny Alexander , Jäger Carsten , Büttner-Herold Maike , Amann Kerstin , Schmaderer Christoph , Heemann Uwe , Wen Ming , Haberfellner Flora , Torrez Carlos , Bachmann Quirin , Kemmner Stephan
Published: October 2020

Background

The small number of organ donors forces transplant centres to consider potentially suboptimal kidneys for transplantation. Eurotransplant established an algorithm for rescue allocation (RA) of kidneys repeatedly declined or not allocated within 5 h after procurement. Data on the outcomes and benefits of RA are scarce to date.

Methods

We conducted a retrospective 8-year analysis of transplant outcomes of RA offers based on our in-house criteria catalogue for acceptance and decline of organs and potential recipients.

Results

RA donors and recipients were both older compared with standard allocation (SA). RA donors more frequently had a history of hypertension, diabetes or fulfilled expanded criteria donor key parameters. RA recipients had poorer human leucocyte antigen (HLA) matches and longer cold ischaemia times (CITs). However, waiting time was shorter and delayed graft function, primary non-function and biopsy-proven rejections were comparable to SA. Five-year graft and patient survival after RA were similar to SA. In multivariate models accounting for confounding factors, graft survival and mortality after RA and SA were comparable as well.

Conclusions

Facing relevant comorbidities and rapid deterioration with the risk of being removed from the waiting list, kidney transplantation after RA was identified to allow for earlier transplantation with excellent outcome. Data from this survey propose not to reject categorically organs from multimorbid donors with older age and a history of hypertension or diabetes to aim for the best possible HLA matching and to carefully calculate overall expected CIT.
Infectious Diseases and Advocacy: This Is our Lane
Authors: Person Anna K
Published: October 2020

The disparate effects of severe acute respiratory syndrome coronavirus 2 virus on communities of color, paired with disjointed federal and local responses to the pandemic and the ongoing examples of structural racism’s effects on health, highlight the need for physician advocacy on behalf of patients. The job of infectious disease physicians has always involved caring for the “whole patient,” but the need for advocacy around issues related to racism, housing, food insecurity, substance use disorders, and mental health has increased. Advocacy at all levels—local, regional, and national—can make a difference and be a profoundly rewarding part of the career of an infectious disease/HIV physician.
Trapped heart in heavily calcified pericardium
Authors: Zaimi Mohd Aizuddin , Mamat Ahmad Zuhdi , Ghazali Mohamad Ziyadi , Zakaria Andee Dzulkarnaen , Sahid Nik Amin , Hayati Firdaus
Published: October 2020

Constrictive pericarditis is a disabling disease of the heart, which causes cardiac diastolic dysfunction. We present a case of a 44-year-old gentleman with a history of blunt chest trauma who presented with constrictive pericarditis with right-sided heart failure. Imaging studies revealed a calcified pericardium. He underwent an uneventful pericardiectomy. Calcification is common yet rare if it involves the pericardium. It normally occurs following fibrosis and adhesion which are associated with the chronicity of the disease, hence creating more challenge to the operating surgeon in the pericardiectomy procedure.
‘Double-hit’ pegylated interferon-alpha successfully treats Hepatitis B and Hepatitis D co-infection
Authors: Bhuva Meha , Moore Marie , Sen Sambit
Published: October 2020

Hepatitis delta (HDV) infection is either acquired simultaneously with, or as a superinfection to, existing Hepatitis B (HBV). It leads to a serious form of chronic viral hepatitis and accelerated liver-related morbidity and mortality including hepatocellular carcinoma. Current treatment regimes propose Pegylated interferon-alpha for 48 weeks however sustained virological response (SVR) rates remain low. We report a patient who initially responded to Pegylated interferon treatment for HBV-HDV co-infection. Although initial improvement in viraemia from both virsues was seen, SVR was not achieved with ongoing progression of liver injury biochemically. However, the summative effect of a second course of Pegylated interferon 2 years later led to HDV cure (SVR 12 months post-treatment), very low level HBV carrier status (with persistently undetectable viral load) and ongoing biochemical normalization. This case illustrates a successful treatment strategy for persistent HBV-HDV co-infection where proposed treatment regimes elicit an initial response but SVR is not achieved.
An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum
Authors: Zainudin Syaza , Rajanthran Saravana Kumar , Azizan Nornazirah , Hayati Firdaus , Ginawoi Joriana , Suhaimi Khairunnisa Aini , Voo Wan Yee Lilian , Kiram Mohd Fazri , Md Jaki Muhammad Izzuddin , Abd Aziz Siti Haja , Nacathiran Subashini Thevi Nach
Published: October 2020

Leiomyoma is a smooth muscle tumour that can arise in any part of the body especially the uterus. Even though it is traditionally linked with hormonal influence, it can also develop in extrauterine organs with a slight female predominance. It is indistinguishable with gastrointestinal stromal tumour (GIST) histologically. We report a case of a 30-year-old gentleman who presented with a huge painful mass in the right iliac fossa. Computed tomography revealed a 10 × 10 cm homogeneous mass arising from the terminal ileum; he subsequently underwent an open right hemicolectomy. Histology showed a well-circumscribed lesion composed of interlacing bundles of smooth muscle fibres of the submucosa with positive smooth muscle actin and H-Caldesmon stains but negative for DOG-1 and CD117 (c-kit) stains which were consistent with leiomyoma. Despite its rarity, this hormone-related tumour needs to be considered regardless of gender. Immunohistochemistry is paramount as it is histologically identical to GIST.
Isolated tuberculosis of the spleen presenting with fever of unknown origin in a vaccinated child
Authors: Kakaje Ameer , Mahmoud Yousef , Hosam Aldeen Osama , Hamdan Othman
Published: October 2020

Tuberculosis (TB) is one of the top 10 causes of death worldwide and is more common in developing countries. Isolated splenic TB is typically found in trauma, miliary TB and immunocompromised status. We present a very rare case of an immunocompetent child with an isolated primary TB in the spleen. The child only had fever of unknown origin (FUO), and mild anaemia. The diagnosis was not made until splenectomy was performed. The patient took the quadruple therapy for TB, and follow-ups showed no recurrence. This case is unique because this child was immunocompetent with no history of trauma or active TB. TB diagnosis should never be ignored in FUO as this might prevent unnecessary procedures to the patient. Although the child was vaccinated with Bacillus Calmette–Guérin that usually protects against severe TB in first 5 years of life, it did not prevent from affecting the spleen.
A case of Falciparum malaria presenting with features of functional bowel obstruction
Authors: Albashir Ahmed Abdalazim Dafallah
Published: October 2020

Malaria is the most common tropical disease in Sudan, which is caused by an infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Headache, fever, cough, fatigue, malaise, shaking chills, arthralgia and myalgia are the cardinal features of malaria, but occasionally, it has an atypical presentation. Intestinal obstruction as a complication is an extremely rare presentation. Here within, we describe a 28-year-old Sudanese man who has presented with of colicky abdominal pain, absolute constipation for two days and fever. Blood film for malaria was positive for Plasmodium falciparum. Intravenous artesunate injections have resulted in the resolution of symptoms of bowel obstruction. In conclusion, malaria should be suspected in any febrile patient with the features of bowel obstruction especially in an endemic area or if the patient has recently travelled to an endemic area with malaria. Treatment of malaria will result in the resolution of symptoms of functional bowel obstruction.
Distribution of physical parameters for 380 contact binaries in the Kepler field
Authors: Li Xu-Zhi , Liu Liang , Zhu Li-Ying
Published: October 2020

We present the physical parameters (p, T, q, i, f) of 380 Kepler contact binary systems (hereafter called CBs). A statistical study on the CBs is carried out based on a Kepler photometric database. Our samples were selected from the Kepler Eclipsing Binary Catalogue of EW-type eclipsing binaries with periods around 0.2–1 d and amplitudes greater than $5\%$. The physical parameters were obtained by fitting the Kepler light curves with the Wilson–Devinney eclipsing binary modeling program. Our sample of CBs contains 160 A-type and 220 W-type CBs. The fill-out factor distribution indicated that CBs generally have shallow fill-out; the proportion of CBs with fill-out factors less than $30\%$ is around $70\%$, which may be related to the formation and evolution of the CBs. The period–temperature relationship of CBs is consistent with previous studies, which is the well-known period–color relationship. The distribution between mass ratio and fill-out factor can provide some information for studying the deep, low-mass ratio contact binaries and CBs which have a large mass ratio. The mass–radius diagram shows that there is a similar linear relationship between the primary and secondary stars while the primary stars are located almost on the ZAMS line; this could be related to the internal nuclear reaction within the primary and secondary stars.
Comparing scoring systems for prediction of mortality in patients with bloodstream infection
Authors: Wellbelove Z , Walsh C , Barlow G D , Lillie P J
Published: October 2020

Background

Blood stream infections (BSIs) are associated with significant short-term mortality. There are many different scoring systems for assessing the severity of BSI.

Aim

We studied confusion, urea, respiratory rate, blood pressure, age 65(CURB65), Confusion Respiratory Rate, Blood pressure, age 65(CRB65), quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS) and National Early Warning Score (NEWS) and assessed how effective they were at predicting 30-day mortality across three separate BSI cohorts.

Design

A retrospective analysis was performed on three established BSI cohorts: (i) All cause BSI, (ii) Escherichia coli and (iii) Streptococcus pneumoniae.

Methods

The performance characteristics (sensitivity, specificity, positive predictive value, negative predictive value and area under receiver operating curve [AUROC]) for the prediction of 30-day mortality were calculated for the 5 scores using clinically relevant cut-offs.

Results

528 patients were included: All cause BSI—148, E. coli—191 and S. pneumoniae—189. Overall, 30-day mortality was 22%. In predicting mortality, the AUROC for CURB65 and CRB65 were superior compared with qSOFA, SIRS and NEWS in the all cause BSI (0.72, 0.70, 0.66, 0.51 and 0.53) and E. coli cohorts (0.81, 0.76, 0.73, 0.55 and 0.71). In the pneumococcal cohort, CURB65, CRB65, qSOFA and NEWS were broadly equal (0.63, 0.65, 0.66 and 0.62), but all were superior to SIRS (0.57). CURB65, CRB65 and qSOFA had considerably higher accuracy than SIRS or NEWS across all cohorts.

Conclusion

CURB65 was superior to other scores in predicting 30-day mortality in the E. coli and all cause BSI cohorts. Further research is required to assess the potential of broadening the application of CURB65 beyond pneumonia.
Understanding Cultural Persistence and Change
Authors: Giuliano Paola , Nunn Nathan
Published: October 2020

We examine a determinant of cultural persistence that has emerged from a class of models in evolutionary anthropology: the similarity of the environment across generations. Within these models, when the environment is more stable across generations, the traits that have evolved up to the previous generation are more likely to be suitable for the current generation. In equilibrium, a greater value is placed on tradition and there is greater cultural persistence. We test this hypothesis by measuring the variability of climatic measures across 20-year generations from 500 to 1900. Employing a variety of tests that use different samples and empirical strategies, we find that populations with ancestors who lived in environments with more cross-generational instability place less importance on maintaining tradition today and exhibit less cultural persistence.