bluuebunny/crossref_metadata_2025 huggingface dataset:
Urine S-Adenosylmethionine are Related to Degree of Renal Insufficiency in Patients with Chronic Kidney Disease
Authors: Kruglova Maria Petrovna , Ivanov Alexander Vladimirovich , Virus Edward Danielevich , Bulgakova Polina Olegovna , Samokhin Andrey Segeevich , Fedoseev Anatolij Nikolaevich , Grachev Sergej Vital’evich , Kubatiev Aslan Amirkhanovich
Published: May 2020

Objective

To determine whether urine S-adenosylmethionine (SAM) might be an indicator of chronic kidney disease (CKD).

Methods

We investigated urine levels of SAM and related metabolites (S-adenosylhomocysteine and homocysteine cysteine) in 62 patients (average age, 65.9 years) with CKD (stages II–V).

Results

Patients with stages III–V CKD stages have significantly decreased urine levels and SAM/S-adenosylhomocysteine ratio and also cysteine/homocysteine ratio in blood plasma (P <.05), compared with patients with stage II CKD. Urine SAM levels allowed us to distinguish patients with mildly decreased kidney function from those with moderate to severe renal impairment (AUC, 0.791; sensitivity, 85%; specificity, 78.6%).

Conclusions

Our study results demonstrate that urine SAM is a potent biomarker for monitoring renal function decline at early CKD stages. Urine SAM testing confers an additional advantage to healthcare professionals in that it is noninvasive.
Systematic errors in strong gravitational lensing reconstructions, a numerical simulation perspective
Authors: Enzi Wolfgang , Vegetti Simona , Despali Giulia , Hsueh Jen-Wei , Benton Metcalf R
Published: May 2020

We present the analysis of a sample of 24 SLACS-like galaxy–galaxy strong gravitational lens systems with a background source and deflectors from the Illustris-1 simulation. We study the degeneracy between the complex mass distribution of the lenses, substructures, the surface brightness distribution of the sources, and the time delays. Using a novel inference framework based on Approximate Bayesian Computation, we find that for all the considered lens systems, an elliptical and cored power-law mass density distribution provides a good fit to the data. However, the presence of cores in the simulated lenses affects most reconstructions in the form of a Source Position Transformation. The latter leads to a systematic underestimation of the source sizes by 50 per cent on average, and a fractional error in H0 of around $25_{-19}^{+37}$ per cent. The analysis of a control sample of 24 lens systems, for which we have perfect knowledge about the shape of the lensing potential, leads to a fractional error on H0 of $12_{-3}^{+6}$ per cent. We find no degeneracy between complexity in the lensing potential and the inferred amount of substructures. We recover an average total projected mass fraction in substructures of fsub < 1.7–2.0 × 10−3 at the 68 per cent confidence level in agreement with zero and the fact that all substructures had been removed from the simulation. Our work highlights the need for higher resolution simulations to quantify the lensing effect of more realistic galactic potentials better, and that additional observational constraint may be required to break existing degeneracies.
Examining supernova events in Type 1 active galactic nuclei
Authors: Villarroel Beatriz , Imaz Iñigo , Lusso Elisabeta , Comerón Sébastien , Prieto M Almudena , Marziani Paola , Mattsson Lars
Published: May 2020

A statistical study of intermediate Palomar Transient Factory supernovae (SNe) in Type 1 active galactic nuclei (AGNs) has shown a major deficit of supernovae around Type 1 AGN host galaxies, with respect to Type 2 AGN hosts. The aim of this work is to test whether there is any preference for Type 1 AGNs to host SN of a specific kind. Through the analysis of SN occurrence and their type (thermonuclear versus core-collapse), we can directly link the type of stars producing the SN events, thus this is an indirect way to study host galaxies in Type 1 AGNs. We examine the detection fractions of SNe, the host galaxies and compare the sample properties to typical host galaxies in the Open Supernova Catalog (OSC). The majority of the host galaxies in the AGN sample are late type, similar to typical galaxies hosting SN within the OSC. The findings are supportive of a deficiency of SNe near Type 1 AGNs, although we cannot with certainty assess the overall detection fractions of SNe in Type 1 AGNs relative to other SN host galaxies. We can state that Type 1 AGN has equal detection fractions of thermonuclear versus core-collapse SNe. However, we note the possibility of a higher detection rate of core-collapse supernovae in Type 1 AGN with insecure AGN classifications.
SHARP – VI. Evidence for CO (1–0) molecular gas extended on kpc-scales in AGN star-forming galaxies at high redshift
Authors: Spingola C , McKean J P , Vegetti S , Powell D , Auger M W , Koopmans L V E , Fassnacht C D , Lagattuta D J , Rizzo F , Stacey H R , Sweijen F
Published: May 2020

We present a study of the stellar host galaxy, CO (1–0) molecular gas distribution and AGN emission on 50–500 pc-scales of the gravitationally lensed dust-obscured AGN MG J0751+2716 and JVAS B1938+666 at redshifts 3.200 and 2.059, respectively. By correcting for the lensing distortion using a grid-based lens modelling technique, we spatially locate the different emitting regions in the source plane for the first time. Both AGN host galaxies have 300–500 pc-scale size and surface brightness consistent with a bulge/pseudo-bulge, and 2 kpc-scale AGN radio jets that are embedded in extended molecular gas reservoirs that are 5–20 kpc in size. The CO (1–0) velocity fields show structures possibly associated with discs (elongated velocity gradients) and interacting objects (off-axis velocity components). There is evidence for a decrement in the CO (1–0) surface brightness at the location of the host galaxy, which may indicate radiative feedback from the AGN, or offset star formation. We find CO–H2 conversion factors of around αCO = 1.5 ± 0.5 (K km s−1 pc2)−1, molecular gas masses of >3 × 1010 M⊙, dynamical masses of ∼1011 M⊙, and gas fractions of around 60 per cent. The intrinsic CO line luminosities are comparable to those of unobscured AGN and dusty star-forming galaxies at similar redshifts, but the infrared luminosities are lower, suggesting that the targets are less efficient at forming stars. Therefore, they may belong to the AGN feedback phase predicted by galaxy formation models, because they are not efficiently forming stars considering their large amount of molecular gas.
The VISTA Variables in the Vía Láctea infrared variability catalogue (VIVA-I)
Authors: Ferreira Lopes C E , Cross N J G , Catelan M , Minniti D , Hempel M , Lucas P W , Angeloni R , Jablonsky F , Braga V F , Leão I C , Herpich F R , Alonso-García J , Papageorgiou A , Pichara K , Saito R K , Bradley A J , Beamin J C , Cortés C , De Medeiros J R , Russell Christopher M P
Published: May 2020

High extinction and crowding create a natural limitation for optical surveys towards the central regions of the Milky Way, where the gas and dust are mainly confined. Large-scale near-infrared (IR) surveys of the Galactic plane and bulge are a good opportunity to explore open scientific questions as well as to test our capability to explore future data sets efficiently. Thanks to the VISTA Variables in the Vía Láctea (VVV) ESO public survey, it is now possible to explore a large number of objects in those regions. This paper addresses the variability analysis of all VVV point sources having more than 10 observations in VVVDR4 using a novel approach. In total, the near-IR light curves of 288 378 769 sources were analysed using methods developed in the New Insight Into Time Series Analysis project. As a result, we present a complete sample having 44 998 752 variable star candidates (VVV-CVSC), which include accurate individual coordinates, near-IR magnitudes (Z,Y,J, and Hs), extinctions A(Ks), variability indices, periods, amplitudes, among other parameters to assess the science. Unfortunately, a side effect of having a highly complete sample, is also having a high level of contamination by non-variable (contamination ratio of non-variables to variables is slightly over 10:1). To deal with this, we also provide some flags and parameters that can be used by the community to decrease the number of variable candidates without heavily decreasing the completeness of the sample. In particular, we cross-identified 339 601 of our sources with Simbad and AAVSO data bases, which provide us with information for these objects at other wavelengths. This subsample constitutes a unique resource to study the corresponding near-IR variability of known sources as well as to assess the IR variability related with X-ray and gamma-ray sources. On the other hand, the other ${\sim }99.5{{\ \rm per\ cent}}$ sources in our sample constitutes a number of potentially new objects with variability information for the heavily crowded and reddened regions of the Galactic plane and bulge. The present results also provide an important queryable resource to perform variability analysis and to characterize ongoing and future surveys like TESS and LSST.
Which bright fast radio bursts repeat?
Authors: James C W , Osłowski S , Flynn C , Kumar P , Bannister K , Bhandari S , Farah W , Kerr M , Lorimer D R , Macquart J-P , Ng C , Phillips C , Price D C , Qiu H , Shannon R M , Spiewak R
Published: May 2020

A handful of fast radio bursts (FRBs) are now known to repeat. However, the question remains – do they all? We report on an extensive observational campaign with the Australian Square Kilometre Array Pathfinder (ASKAP), Parkes, and Robert C. Byrd Green Bank Telescope, searching for repeat bursts from FRBs detected by the Commensal Real-time ASKAP Fast Transients survey. In 383.2 h of follow-up observations covering 27 FRBs initially detected as single bursts, only two repeat bursts from a single FRB, FRB 171019, were detected, which have been previously reported by Kumar et al. We use simulations of repeating FRBs that allow for clustering in burst arrival times to calculate new estimates for the repetition rate of FRB 171019, finding only slight evidence for incompatibility with the properties of FRB 121102. Our lack of repeat bursts from the remaining FRBs set limits on the model of all bursts being attributable to repeating FRBs. Assuming a reasonable range of repetition behaviour, at most 60 per cent (90 per cent confidence limit) of these FRBs have an intrinsic burst distribution similar to FRB 121102. This result is shown to be robust against different assumptions on the nature of repeating FRB behaviour, and indicates that if indeed all FRBs repeat, the majority must do so very rarely.
Application of the screened Coulomb potential to fit the DA-type variable star HS 0507 + 0434B
Authors: Chen Y H
Published: May 2020

wdec is used to evolve grids of DA-variable (DAV) star models adopting the element diffusion scheme with pure and screened Coulomb potentials. The core compositions are thermonuclear burning results derived from mesa. mesa yields composition profiles that the version of wdec used in this work could not accommodate (most notably, the presence of helium in the core of the model). According to the theory of rotational splitting, Fu and colleagues identified six triplets for the DAV star HS 0507 + 0434B based on 206 h of photometric data. The grids of DAV star models are used to fit the six reliable m = 0 modes. When adopting the screened Coulomb potential, a best-fitting model of log(MHe/M*) = −3.0, log(MH/M*) = −6.1, Teff = 11 790 K, M* = 0.625 M⊙, log g = 8.066 and σRMS = 2.08 s was obtained. Compared with adopting the pure Coulomb potential, the value of σRMS is improved by 34 per cent. This study may provide a new method for research into mode-trapping properties.
Formation of massive globular clusters with dark matter and its implication on dark matter annihilation
Authors: Wirth Henriette , Bekki Kenji , Hayashi Kohei
Published: May 2020

Recent observational studies of γ-ray emission from massive globular clusters (GCs) have revealed possible evidence of dark matter (DM) annihilation within GCs. It is, however, still controversial whether the emission comes from DM or from millisecond pulsars. We here present the new results of numerical simulations, which demonstrate that GCs with DM can originate from nucleated dwarfs orbiting the ancient Milky Way. The simulated stripped nuclei (i.e. GCs) have the central DM densities ranging from 0.1 to several M⊙ pc−3, depending on the orbits and the masses of the host dwarf galaxies. However, GCs born outside the central regions of their hosts can have no/little DM after their hosts are destroyed and the GCs become the Galactic halo GCs. These results suggest that only GCs originating from stellar nuclei of dwarfs can possibly have DM. We further calculate the expected γ-ray emission from these simulated GCs and compare them to observations of ω Cen. Given the large range of DM densities in the simulated GCs, we suggest that the recent possible detection of DM annihilation from GCs should be more carefully interpreted.
Mandated Representation: Exploring the Consequences of Gender Quota Design on Parliamentary Activity
Authors: Euchner Eva-Maria , Frech Elena
Published: May 2020

Although the scholarship on legislative behaviour widely agrees that electoral rules determine parliamentary activities, surprisingly little is known on the impact of gender quotas. We contribute to this research gap by developing an innovative interdisciplinary framework and by exploring it based on a unique dataset on varying gender quota designs throughout EU countries and parties running for the 7th term of the European Parliament (2009–2014). Based on the scholarship on gender diversity in management teams and the research on gendered processes in political parties, we argue that especially mandated gender quotas stimulate processes of social categorisation, intergroup biasing and competition due to a normative mis-fit between conceptions of gender equality and gender quotas, which in turn influences coordination and communication and hence, parliamentary activity more generally. Combining negative-binomial regression models and expert interviews, we indeed find that mandated gender quotas promote ‘individual’ parliamentary activities (e.g. speeches) and tend to impede ‘collaborative’ parliamentary activities (e.g. reports).
Early Detection of In-Patient Deterioration: One Prediction Model Does Not Fit All
Authors: Blackwell Jacob N. , Keim-Malpass Jessica , Clark Matthew T. , Kowalski Rebecca L. , Najjar Salim N. , Bourque Jamieson M. , Lake Douglas E. , Moorman J. Randall
Published: May 2020

Objectives:

Early detection of subacute potentially catastrophic illnesses using available data is a clinical imperative, and scores that report risk of imminent events in real time abound. Patients deteriorate for a variety of reasons, and it is unlikely that a single predictor such as an abnormal National Early Warning Score will detect all of them equally well. The objective of this study was to test the idea that the diversity of reasons for clinical deterioration leading to ICU transfer mandates multiple targeted predictive models.

Design:

Individual chart review to determine the clinical reason for ICU transfer; determination of relative risks of individual vital signs, laboratory tests and cardiorespiratory monitoring measures for prediction of each clinical reason for ICU transfer; and logistic regression modeling for the outcome of ICU transfer for a specific clinical reason.

Setting:

Cardiac medical-surgical ward; tertiary care academic hospital.

Patients:

Eight-thousand one-hundred eleven adult patients, 457 of whom were transferred to an ICU for clinical deterioration.

Interventions:

None.

Measurements and Main Results:

We calculated the contributing relative risks of individual vital signs, laboratory tests and cardiorespiratory monitoring measures for prediction of each clinical reason for ICU transfer, and used logistic regression modeling to calculate receiver operating characteristic areas and relative risks for the outcome of ICU transfer for a specific clinical reason. The reasons for clinical deterioration leading to ICU transfer were varied, as were their predictors. For example, the three most common reasons—respiratory instability, infection and suspected sepsis, and heart failure requiring escalated therapy—had distinct signatures of illness. Statistical models trained to target-specific reasons for ICU transfer performed better than one model targeting combined events.

Conclusions:

A single predictive model for clinical deterioration does not perform as well as having multiple models trained for the individual specific clinical events leading to ICU transfer.
Making People Whole Through the Breath of Life
Authors: Seunarine Elizabeth
Published: May 2020

For 50 years, Medical Ministry International has provided healthcare relief and development in 30 countries. Interprofessional teams of local and visiting volunteer workers promote healthcare sustainability, which has become more attainable with the addition of integrated health education based on Jesus' model of wholeness. Instructors teach basic health concepts to community residents while relating truths about God and his Word. Long-term change is evident when teams return to previously visited sites.
Pulmonary function decline in immediate postoperative period is not necessarily related to residual neuromuscular block
Authors: Thudium Marcus , Kornilov Evgeniya , Raczeck Lukas , Boehm Olaf
Published: May 2020

BACKGROUND

Previous studies have reported an association between the use of neuromuscular blocking (NMB) agents and postoperative pulmonary complications. Postoperative pulmonary function is a key indicator for postoperative pulmonary complications. Several sites can be used to assess depth and recovery from NMB.

OBJECTIVES

To investigate postoperative pulmonary function change in relation to train-of-four measurements at the adductor pollicis and corrugator supercilii muscles, and anaesthesia-related variables in orthopaedic patients undergoing hip or knee arthroplasty.

DESIGN

Observational study.

SETTING

University hospital.

PATIENTS

Orthopaedic patients undergoing hip or knee arthroplasty.

MAIN OUTCOME MEASURES

Postoperative pulmonary function tests in the postanaesthesia care unit.

METHODS

Patients scheduled for elective hip or knee arthroplasty received simultaneous corrugator supercilii and adductor pollicis measurements during anaesthesia conducted according to clinical standards. Forced expiratory volume in 1 s and forced vital capacity (FVC) were measured at the time of inclusion and postoperatively on the postanaesthesia care unit. Linear regression analysis was performed for association between risk factors and pulmonary function change.

RESULTS

A total of 35 patients were included. After exclusions, 20 patients remained for final analysis. Corrugator supercilii showed earlier NMB recovery than adductor pollicis. FVC decreased significantly after surgery from 2.9 ± 1.0 to 2.3 ± 1.0 (P < 0.01) and forced expiratory volume in 1 s decreased from 2.3 ± 0.9 to 1.6 ± 0.8 l (P < 0.01). Patient age was the only factor significantly related to FVC decrease after surgery (P = 0.019) with a cut-off value of 65 years.

CONCLUSION

Both corrugator supercilii and adductor pollicis failed to indicate recovery of pulmonary function after NMB. Age seems to be a risk factor for postoperative decline in pulmonary function.

TRIAL REGISTRATION

German Clinical Trials registry, DRKS-ID: DRKS00014305.
Optimizing outcomes for keratoplasty in ectatic corneal disease
Authors: Yu Angeli Christy , Mattioli Leila , Busin Massimo
Published: May 2020

Purpose of review

Advanced keratectasia often requires corneal transplantation for restoration of vision. This review discusses the surgical approach suitable for these cases including significant updates in the current literature.

Recent findings

With greater understanding of ectatic corneal disease and its associated operative challenges, several modifications in the surgical approach have been developed. Identified predictive factors for successful pneumatic dissection and intraoperative complications have informed surgical planning and decision-making. In the setting of failed pneumatic dissection, sequential use of alternative lamellar dissection techniques is a reasonable surgical strategy. Surgical refinements to optimize visual outcomes and postoperative interventions to correct residual refractive errors have improved visual rehabilitation after keratoplasty.

With evidence of its undisputed advantages, DALK has been widely recognized as the primary surgical option for ectatic corneal disease.
Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction
Authors: Pritchett Michael A. , Bhadra Krish , Mattingley Jennifer S.
Published: May 2020

Background:

Electromagnetic navigation bronchoscopy (ENB) aids in lung lesion biopsy. However, anatomic divergence between the preprocedural computed tomography (CT) and the actual bronchial anatomy during the procedure can limit localization accuracy. An advanced ENB system has been designed to mitigate CT-to-body divergence using a tomosynthesis-based software algorithm that enhances nodule visibility and allows for intraprocedural local registration.

Materials and Methods:

A prospective, 2-center study was conducted in subjects with single peripheral lung lesions ≥10 mm to assess localization accuracy of the superDimension navigation system with fluoroscopic navigation technology. Three-dimensional accuracy was confirmed by cone-beam computed tomography. Complications were assessed through 7 days.

Results:

Fifty subjects were enrolled (25 per site). Lesions were <20 mm in 61.2% (30/49). A bronchus sign was present in 53.1% (26/49). Local registration was completed in 95.9% (47/49). Three-dimensional target overlap (primary endpoint) was achieved in 59.6% (28/47) and 83.0% (39/47) before and after location correction, respectively. Excluding subjects with unevaluable video files, target overlap was achieved 68.3% (28/41) and 95.1% (39/41), respectively. Malignant results were obtained in 53.1% (26/49) by rapid on-site evaluation and 61.2% (30/49) by final pathology of the ENB-aided sample. Diagnostic yield was not evaluated. Procedure-related complications were pneumothorax in 1 subject (no chest tube required) and scant hemoptysis in 3 subjects (no interventions required).

Conclusion:

ENB with tomosynthesis-based fluoroscopic navigation improved the 3-dimensional convergence between the virtual target and actual lung lesion as confirmed by cone-beam computed tomography. Future studies are necessary to understand the impact of this technology on diagnostic yield.
Predicting the CN Lantern Test for Railways with Clinical Color-vision Tests
Authors: Almustanyir Ali , Hovis Jeffery K.
Published: May 2020

SIGNIFICANCE

This research will help clinicians in advising their color-vision–defective patients regarding their career options.

PURPOSE

In Canadian railways, individuals with a color-vision-defect (CVD) may qualify for positions at shorter sighting distance from signal lights. The railway companies' medical units use the CN Lantern (CNLan) test, and there is little information available as to whether clinical color-vision tests (CCVTs) can predict the CNLan results. This study determines the ability of some CCVTs to predict the CNLan performance to assist clinicians in advising their CVD patients regarding career options.

METHODS

The CNLan viewing distance was varied between 4.6 and 0.57 m using a geometric progression. The CCVTs were the Hardy, Rand, and Rittler; Ishihara; ColorDx pseudoisochromatic plate (PIP); the Rabin Cone Contrast Test; Color Assessment and Diagnosis; Cambridge Color Vision Test; U.S. Air Force Operational Based Vision Assessment Cone Contrast Test; Farnsworth Munsell D15; and ColorDx D15. Fifty-six normal-color-vision and 63 CVD subjects participated in this study.

RESULTS

Failure of either the Farnsworth Munsell D15 or ColorDx D15 essentially guarantees failure on the CNLan at the 4.6-m distance. The agreement values decreased as the viewing distance decreased.

CONCLUSIONS

To counsel patients regarding a career as a locomotive engineer, clinicians should have either the Hardy, Rand, and Rittler or ColorDx PIP and a D15 test. For patients applying for a position in the yard, a mild-to-moderate classification CVD on HRR or ColorDx PIP indicates a high probability of passing CNLan.
Pseudopartial Third Nerve Palsy as the Presenting Sign of Ocular Myasthenia Gravis
Authors: Bertolet Anne N. , Druckenbrod Rachel C.
Published: May 2020

SIGNIFICANCE

This case emphasizes the high degree of suspicion necessary for a timely diagnosis of myasthenia gravis.

PURPOSE

This report discusses a case of ocular myasthenia gravis presenting as a pseudo–third nerve palsy with ptosis. The pathogenesis, treatment, and management of ocular myasthenia gravis are discussed.

CASE REPORT

A 68-year-old white man presented to our clinic after noticing a new right eyelid droop for several days and experiencing horizontal double vision for the past 3 weeks. A pupil-sparing partial third nerve palsy was diagnosed, and MRI and laboratory work were ordered to assist with diagnosis. Laboratory results demonstrated highly positive acetylcholinesterase antibodies, confirming a diagnosis of ocular myasthenia gravis.

CONCLUSIONS

Myasthenia gravis commonly presents with ocular signs and symptoms. Because ocular myasthenia gravis can mimic other causes of diplopia, heightened awareness and suspicion are necessary to make a timely diagnosis.
Social Integration and Diurnal Cortisol Decline: The Role of Psychosocial and Behavioral Pathways
Authors: Dickman Kristina D. , Thomas Mark C. , Anderson Barbara , Manuck Stephen B. , Kamarck Thomas W.
Published: May 2020

Objective

A growing number of studies have associated various measures of social integration, the diversity of social roles in which one participates, with alterations in hypothalamic-pituitary-adrenocortical (HPA) functioning. The pathways through which social integration may be linked to HPA functioning, however, are as yet unknown. The present study examined whether daily social interactions, affective responses, health behaviors, and personality help explain the association between social integration and diurnal cortisol slope.

Methods

A sample of 456 healthy, employed adults (53.9% female, 82.0% white, 72.2% bachelor’s degree or greater, mean age of 42.86 years) completed a 4-day ecological momentary assessment protocol that measured cortisol, social interactions, affect, sleep, and physical activity at frequent intervals throughout the day. Social integration was measured at baseline.

Results

Regression results controlling for age, sex, race, and education indicated that more socially integrated individuals showed steeper cortisol slopes (B= −0.00253,p= .006). Exploratory analyses suggested that the consistency (i.e., reduced variability) in nightly sleep midpoint partially explained this association (B= −0.00042, 95% confidence interval = −0.00095 to −0.00001). Personality, mood, social interaction patterns, and nonsleep health behavior differences did not account for the association between social integration and HPA activity.

Conclusion

This study replicates previous findings linking social integration and HPA functioning, and it examines patterns of nightly sleep as possible pathways through which the association may operate. Results have implications for understanding mechanisms for health risk and for development of future interventions.
The Association of Individual Changes in Stressful Life Events and Telomere Length Over Time in Twins 50 Years and Older
Authors: Gerritsen Lotte , Hägg Sara , Reynolds Chandra A. , Pedersen Nancy L.
Published: May 2020

Objective

Exposure to adverse stressors has been associated with shortening of leukocyte telomere length (LTL). The present longitudinal study investigates the time course of exposure to life events and LTL to determine whether increases in exposure to life events are related to subsequent accelerated LTL shortening.

Methods

In the Swedish Adoption/Twin Study of Aging, we assessed late-life stressful events and LTL in 543 individual participants (mean age = 68.4 years, 40% men, including 48 complete monozygotic twin pairs and 167 complete dizygotic twin pairs) in up to five separate measurements over a period of 25 years. LTL was measured using quantitative polymerase chain reaction. Longitudinal analyses were conducted using time-varying mixed modeling, corrected for life-style factors and depressive symptoms.

Results

When adjusting for differences in genetic makeup by looking only in monozygotic twins, we found that an increase in life stressors within an individual was related to decreased LTL over time (B = −0.02; 95% confidence interval = −0.04 to 0.01; p = .002). None of the findings were significant when only looking at dizygotic twins (all, p > .05).

Conclusions

Our findings in an older population show a causal relation between increase in life stress and accelerated LTL shortening by using intraindividual time-varying analysis.
Mind the Gap: Changes in Levator Dimensions After Sacrocolpopexy
Authors: Geynisman-Tan Julia , Kenton Kimberly S. , Brown Oluwateniola , Gillingham Akira , Lewicky-Gaupp Christina , Mueller Margaret G. , Collins Sarah A.
Published: May 2020

Objective

The aim of the study was to compare levator hiatus (LH) and levator area (LA) on transvaginal 3-dimensional (3D) ultrasound (US) and genital hiatus (GH) size by Pelvic Organ Prolapse Quantification (POP-Q) examination before and after minimally invasive sacrocolpopexy.

Methods

Women with prolapse (POP) beyond the hymen undergoing minimally invasive sacrocolpopexy without concomitant POP repairs completed Pelvic Floor Distress Inventory short form (PFDI), POP-Q, and transvaginal 3D US before and 14 weeks after surgery. Data were analyzed by 2 urogynecologists, blinded to US image sequence and to corresponding POP-Q scores.

Results

Forty-three patients were enrolled; 35 with complete data are included. Patients had a mean ± SD age of 55 ± 11 years. Most were white (89%), vaginally parous (94%), postmenopausal (66%), sexually active (63%), and had stage 3 POP (86%). The majority (89%) had concomitant hysterectomy, and 60% had midurethral slings. At baseline, the mean ± SD PFDI and Prolapse subscale of the Pelvic Floor Distress Inventory scores were 98 ± 50 and 42 ± 22. The median (interquartile range) POP-Q stage decreased after surgery from 3 (3) to 0 (0–1, P < 0.001) and the mean ± SD PFDI scores decreased to 55 ± 42 (P = 0.002). At baseline, the mean ± SD GH and perineal body measurements were 3.5 ± 0.7 and 2.4 ± 0.6 cm. Although the GH size decreased by 0.5 cm after surgery, perineal body was unchanged. Levator hiatus remained unchanged between the baseline and 14-week visits (P = 0.07), whereas LA increased by 0.8 cm2 (P = 0.03). At 14 weeks, the change in LA was not correlated with the change in GH (ρ = −0.2, P = 0.2) or POP stage (ρ = −0.2, P = 0.9).

Conclusions

Restoring the apex with sacrocolpopexy alone reduces GH size on clinical examination; however, it does not impact the size of the underlying LH on US.
On the Generation of Medical Dialogues for COVID-19
Authors: Yang Wenmian , Zeng Guangtao , Tan Bowen , Ju Zeqian , Chakravorty Subrato , He Xuehai , Chen Shu , Yang Xingyi , Wu Qingyang , Yu Zhou , Xing Eric , Xie Pengtao
Published: May 2020

Under the pandemic of COVID-19, people experiencing COVID19-related symptoms or exposed to risk factors have a pressing need to consult doctors. Due to hospital closure, a lot of consulting services have been moved online. Because of the shortage of medical professionals, many people cannot receive online consultations timely. To address this problem, we aim to develop a medical dialogue system that can provide COVID19-related consultations. We collected two dialogue datasets – CovidDialog – (in English and Chinese respectively) containing conversations between doctors and patients about COVID-19. On these two datasets, we train several dialogue generation models based on Transformer, GPT, and BERT-GPT. Since the two COVID-19 dialogue datasets are small in size, which bear high risk of overfitting, we leverage transfer learning to mitigate data deficiency. Specifically, we take the pretrained models of Transformer, GPT, and BERT-GPT on dialog datasets and other large-scale texts, then finetune them on our CovidDialog datasets. Experiments demonstrate that these approaches are promising in generating meaningful medical dialogues about COVID-19. But more advanced approaches are needed to build a fully useful dialogue system that can offer accurate COVID-related consultations. The data and code are available at https://github.com/UCSD-AI4H/COVID-Dialogue
Behaviours and attitudes in response to the COVID-19 pandemic: Insights from a cross-national Facebook survey
Authors: Perrotta Daniela , Grow André , Rampazzo Francesco , Cimentada Jorge , Fava Emanuele Del , Gil-Clavel Sofia , Zagheni Emilio
Published: May 2020

In the absence of medical treatment and vaccination, individual behaviours are key to controlling the spread of COVID-19. We developed a rapid response monitoring system through an online survey (the “COVID-19 Health Behavior Survey”). Participant recruitment takes places continuously via Facebook in eight countries (Belgium, France, Germany, Italy, the Netherlands, Spain, the United Kingdom, the United States). The survey collects key information on people’s health, attitudes, behaviours, and social contacts. In this paper, we present results based on a total of 71,612 completed questionnaires, collected between March 13-April 19, 2020. We find sex-specific patterns, as women show higher threat perceptions, lower confidence in the healthcare system, and a higher likelihood of adopting preventive behaviours. Our findings also show higher awareness and concern among older respondents. Finally, we find spatio-temporal heterogeneity in threat perception, confidence in organisations, and adoption of preventive behaviours.
COVID-19 and Environmental factors. A PRISMA-compliant systematic review
Authors: Chatziprodromidou I. , Apostolou T. , Vantarakis A.
Published: May 2020

The emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its airborne spread via droplets. The impact of environmental factors on the coronavirus disease 2019 (COVID-19) outbreak is under consideration. We therefore reviewed the literature on all available information about the impact of environmental factors on human coronaviruses. Temperature, humidity and other environmental factors have been recorded as environmental drivers of the COVID-19 outbreak in China and in other countries. Higher temperatures might be positive to decrease the COVID-19 incidence. In our review, the analysis of 23 studies show evidence that high temperature and high humidity reduce the COVID-19 transmission. However, further studies concerning other environmental (namely meteorological) factors’ role should be conducted in order to further prove this correlation.

As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
Psychological Distress during the COVID-19 pandemic in France: a national assessment of at-risk populations
Authors: Chaix Benjamin , Delamon Guillaume , Guillemasse Arthur , Brouard Benoit , Bibault Jean-Emmanuel
Published: May 2020

Introduction
More than 2.5 billion people in the world are currently in lockdowns to limit the spread of the novel coronavirus disease 2019 (COVID-19). Psychological Distress (PD) and Post-Traumatic Stress Disorder have been reported after traumatic events, but the specific effect of pandemics is not well known. The aim of this study was to assess PD in France, a country where COVID-19 had such a dramatic impact that it required a country-wide lockdown.

Patients and methods
We recruited patients in 4 groups of chatbot users followed for breast cancer, asthma, depression and migraine. We used the Psychological Distress Index (PDI), a validated scale to measure PD during traumatic events, and correlated PD risk with patients characteristics in order to better identify the one who were the most at-risk.

Results
The study included 1771 participants. 91.25% (1616) were female with a mean age of 32.8 years (SD=13,71), 7.96% (141) were male with a mean age of 28.0 years (SD=8,14). In total, 38.06% (674) of the respondents had psychological distress (PDI ≥15). An ANOVA analysis showed that sex (p=0.00132), unemployment (p=7.16x10-6) and depression (p=7.49x10-7) were significantly associated with a higher PDI score. Patients using their smartphone or computer more than one hour a day also had a higher PDI score (p=0.02588).

Conclusion
Prevalence of PD in at-risk patients is high. These patients are also at increased risk to develop Post-Traumatic Stress Disorder. Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.
A Virtual Skills Centre on Behaviour Management in Chronic Disease for Lay People in Low- and Middle-Income Countries (LMICs)
Authors: Papachristou Nadal iliatha , Ganapathiram Nivethitha , Harrison Thomas , R Deepa , Karthik Maithili , Mallinson Poppy , Angkurawaranon Chaisiri , Nyirenda Moffat , Babu Giridhar , Kinra Sanjay
Published: May 2020

Introduction: Diabetes complications can be reduced and/or prevented by providing skills in behavioural management to lay people e.g. volunteers, family and friends. With a critical shortage of trained staff in lower- and middle-income countries (LMICs) to deliver these, lay people are a solution to fill this gap. Current programmes in LMICs are not suitable for lay people as they are (i) too complex i.e. for high education professionals and (ii) not easily accessible. We aim to address these two barriers through both a face to face and online virtual skills centre (VSC).

Objectives: This paper describes the development of an online VSC that will provide access to those caring for people with diabetes within a community setting; examined the suitability and usability of the VSC using qualitative methods.

Methods Drawing on the DoTTI framework for developing an online program, the VSC was i) designed and developed using psychological techniques and ii) tested for early iteration using participatory workshops.

Results: A total of 23 participants from Bengaluru, India, both lay and clinicians, tested the VSC. The main themes identified were: empowerment for lay people; suitable for locals in a community setting; local services needed; user-friendly focused.

Conclusion: This study found that a theory and evidence-based approach as the basis for an online behavioural management skills programme was acceptable to users. A substantive pilot will be conducted to examine whether the VSC is effective in reducing/preventing diabetes complications and how to implement into a community setting across other LMICs and chronic diseases.
Impact of COVID-19 epidemic curtailment strategies in selected Indian states: an analysis by reproduction number and doubling time with incidence modelling
Authors: Mitra Arun , Pakhare Abhijit P , Roy Adrija , Joshi Ankur
Published: May 2020

The Government of India in networks with its state government has implemented the epidemic curtailment strategies inclusive of case-isolation, quarantine and lockdown in response to ongoing novel coronavirus (COVID-19) outbreak . In this manuscript we attempt to estimate the effect of these steps across ten Indian states using crowd-sourced data. The chosen transmission parameters are -reproduction number (R0), doubling time and growth rate during the early epidemic phase (15 days into lockdown) and 30 days into lockdown (23rd April 2020) through maximum likelihood approach.
The overall analysis shows the decreasing trends in reproductive numbers and growth rate (with few exceptions) and incremental doubling time. The curtailment strategies employed by the Indian government seemed to be effective in reducing the transmission parameters of the COVID-19 epidemic. The effective reproductive numbers are still higher above the threshold of 1 and the resultant absolute numbers tend to be exponentiating fundamentally. The curtailment strategy thus may take into account these findings while formulating further course of actions.
A collaborative online AI engine for CT-based COVID-19 diagnosis
Authors: Xu Yongchao , Ma Liya , Yang Fan , Chen Yanyan , Ma Ke , Yang Jiehua , Yang Xian , Chen Yaobing , Shu Chang , Fan Ziwei , Gan Jiefeng , Zou Xinyu , Huang Renhao , Zhang Changzheng , Liu Xiaowu , Tu Dandan , Xu Chuou , Zhang Wenqing , Yang Dehua , Wang Ming-Wei , Wang Xi , Xie Xiaoliang , Leng Hongxiang , Holalkere Nagaraj , Halin Neil J. , Kamel Ihab Roushdy , Wu Jia , Peng Xuehua , Wang Xiang , Shao Jianbo , Mongkolwat Pattanasak , Zhang Jianjun , Rubin Daniel L. , Wang Guoping , Zheng Chuangsheng , Li Zhen , Bai Xiang , Xia Tian
Published: May 2020

Artificial intelligence can potentially provide a substantial role in streamlining chest computed tomography (CT) diagnosis of COVID-19 patients. However, several critical hurdles have impeded the development of robust AI model, which include deficiency, isolation, and heterogeneity of CT data generated from diverse institutions. These bring about lack of generalization of AI model and therefore prevent it from applications in clinical practices. To overcome this, we proposed a federated learning-based Unified CT-COVID AI Diagnostic Initiative (UCADI, http://www.ai-ct-covid.team/), a decentralized architecture where the AI model is distributed to and executed at each host institution with the data sources or client ends for training and inferencing without sharing individual patient data. Specifically, we firstly developed an initial AI CT model based on data collected from three Tongji hospitals in Wuhan. After model evaluation, we found that the initial model can identify COVID from Tongji CT test data at near radiologist-level (97.5% sensitivity) but performed worse when it was tested on COVID cases from Wuhan Union Hospital (72% sensitivity), indicating a lack of model generalization. Next, we used the publicly available UCADI framework to build a federated model which integrated COVID CT cases from the Tongji hospitals and Wuhan Union hospital (WU) without transferring the WU data. The federated model not only performed similarly on Tongji test data but improved the detection sensitivity (98%) on WU test cases. The UCADI framework will allow participants worldwide to use and contribute to the model, to deliver a real-world, globally built and validated clinic CT-COVID AI tool. This effort directly supports the United Nations Sustainable Development Goals’ number 3, Good Health and Well-Being, and allows sharing and transferring of knowledge to fight this devastating disease around the world.
Strategic release of lockdowns in a COVID infection model
Authors: Zhang Yi , Hota Mohit , Kapoor Sanjiv
Published: May 2020

The COVID-19 Pandemic has impacted the world's socio-economic system, resulting in a serious health crisis and lockdowns around the world. As the growth of infection slows, decisions regarding easing of lockdown restrictions are required, keeping in view the capacity of the health-care system. In this paper, we quantify the impact of a multi-phased release of the population from lockdown. Using the SIR model for epidemic spread, we design and implement a method to determine the earliest time of release from lockdown restrictions, constrained by a specified threshold on the subsequent peaks of infection. Trade-offs between the threshold and the earliest times of removing lockdown restrictions are illustrated. Additionally, we consider alternative policy decisions where the population is released gradually from lockdown restrictions and illustrate the trade-offs between the rate of release of population and number of active infections.
EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN
Authors: Modig Karin , Ebeling Marcus
Published: May 2020

Objectives

Mortality from Covid-19 is monitored in detail both within as well as between countries with different strategies against the virus. However, death counts and relative risks based on crude numbers can be misleading. Instead, age specific death rates should be used for comparability. Given the difficulty of ascertainment of Covid-19 specific deaths, excess all-cause mortality is currently more appropriate for comparisons. By estimating age- and sex-specific death rates we aim to get more accurate estimates of the excess mortality attributed to Covid-19, as well as the difference between men and women in Sweden.

Design

We make use of Swedish register data about total weekly deaths, total population at risk, and estimate age- and sex-specific weekly death rates for 2020 and the 5 previous years. The data is provided by Statistics Sweden.

Results

From the first week of April and onwards, the death rates at all ages above 60 are higher than those in previous years in Sweden. Persons above age 80 are dis-proportionally more affected, and men suffer higher levels of excess mortality than women at all ages with 75% higher death rates for males and 50% higher for females. Current excess mortality corresponds to a decline in remaining life expectancy of 3 years for men and 2 years for women.

Conclusion

The Covid-19 pandemic has so far had a clear and consistent effect on total mortality in Sweden, with male death rates being comparably more affected. What consequences the pandemic will eventually have on mortality and life expectancy will depend on the progression of the pandemic, the extent that some of the deaths would have occurred in the absence of the pandemic, only somewhat later, the consequences for other health conditions, as well as the health care sector at large.
Upregulation of Human Endogenous Retroviruses in Bronchoalveolar Lavage Fluid of COVID-19 Patients
Authors: Kitsou Konstantina , Kotanidou Anastasia , Paraskevis Dimitrios , Karamitros Timokratis , Katzourakis Aris , Tedder Richard , Hurst Tara , Sapounas Spyros , Kotsinas Athanassios , Gorgoulis Vassilis , Spoulou Vana , Tsiodras Sotirios , Lagiou Pagona , Magiorkinis Gkikas
Published: May 2020

Background: Severe COVID-19 pneumonia has been associated with the development of intense inflammatory responses during the course of infections with SARS-CoV-2. Given that Human Endogenous Retroviruses (HERVs) are known to be activated during and participate in inflammatory processes, we examined whether HERV dysregulation signatures are present in COVID-19 patients.
Results: By comparing transcriptomes of Peripheral Blood Monocytes (PBMCs) and Bronchoalveolar Lavage Fluid (BALF) from patients and normal controls we have shown that HERVs are intensely dysregulated in BALF, but not in PBMCs. In particular, upregulation in the expression of multiple HERV families was detected in BALF samples of COVID-19 patients, with HERV-W being the most highly upregulated family among the families analysed. In addition, we compared the expression of HERVs in Human Bronchial Epithelial Cells (HBECs) without and after senescence induction in an oncogene-induced senescence model, in order to quantitatively measure changes in the expression of HERVs in bronchial cells during the processes of cellular senescence.
Conclusions: This apparent difference of HERV dysregulation between PBMCs and BALF warrants further studies in involvement of HERVs in inflammatory pathogenetic mechanisms as well as exploration of HERVs as potential biomarkers for disease progression. Furthermore, the increase in the expression of HERVs in senescent HBECs in comparison to non-induced HBECs provides a potential link for increased COVID-19 severity and mortality in aged populations.