bluuebunny/crossref_metadata_2025 huggingface dataset:
Probable Case of Vertical Transmission of SARS-CoV-2 in a Newborn in Mexico
Authors: Mendoza-Hernández Marcela , Huerta-Niño de Rivera Ivette , Yoldi-Negrete María , Saviñon-Tejeda Pamela , Franco-Cendejas Rafael , López-Jácome Luis Esaú , Navarro-Castellanos Iñaki
Published: May 2021

Background: Much remains unknown about the transmission of the SARS-CoV-2 virus. Pregnant women are considered part of the risk population, and vertical transmission of other coronaviruses has been suggested; however, this type of transmission in SARS-CoV-2 is believed to be unlikely. Case Report: A newborn delivered in term via cesarean section to an asymptomatic but COVID-19-positive 35-year-old woman started with respiratory distress in the first 30 min of life. A chest radiograph revealed pneumothorax and ground glass opacities. Ventilatory support with continuous positive airway pressure was needed. Given the respiratory failure and the positive test from the mother, the patient was sampled for SARS-CoV-2 (RT-PCR) at minute 30 of life, with a positive result reported at 36 h of life. No complications had been present during pregnancy, and cardiac screening and blood cultures revealed no other etiologies. Conclusion: Vertical transmission was highly likely in this case. Clinicians should be alert and report similar cases.
Comparative Efficacy of Atezolizumab plus Bevacizumab and Other Treatment Options for Patients with Unresectable Hepatocellular Carcinoma: A Network Meta-Analysis
Authors: Vogel Arndt , Rimassa Lorenza , Sun Hui-Chan , Abou-Alfa Ghassan K. , El-Khoueiry Anthony , Pinato David J. , Sanchez Alvarez Javier , Daigl Monica , Orfanos Panos , Leibfried Michael , Blanchet Zumofen Marie-Hélène , Gaillard Vincent E. , Merle Philippe
Published: May 2021

Background: Most phase 3 clinical trials of systemic therapy for first-line unresectable hepatocellular carcinoma (HCC) have failed, with the exception of SHARP, REFLECT, and IMbrave150. We conducted indirect comparisons of therapies evaluated for first-line HCC treatment. Summary: We conducted a systematic review and meta-analysis of treatments for adults with locally advanced or metastatic unresectable HCC and no prior systemic treatment, including atezolizu­mab plus bevacizumab, sorafenib, lenvatinib, nivolumab, selective internal radiotherapy (SIRT), transarterial chemoembolization, and placebo or best supportive care. Randomized controlled trials published from January 1, 2007, to March 12, 2020, were retrieved from MEDLINE and Embase. Qualitative assessment of heterogeneity evaluated study designs, populations, and outcomes. Indirect comparisons used generalized linear models with random effects within a Bayesian framework and informative priors. We calculated relative efficacy estimates with 95% credible intervals (CrIs) and Bayesian posterior probability estimates of atezolizumab-bevacizumab being superior to other treatments. Nine clinical studies with a total of 3,897 participants were identified from 8,783 records and used to build the all-trials evidence network. Indirect comparisons suggested an improved overall survival (OS) with atezolizumab-bevacizumab versus lenvatinib (odds ratio, 0.63 [95% CrI 0.39–1.04]; with 97% Bayesian posterior probability of being superior), nivolumab (0.68 [95% CrI 0.41–1.14]; 94%), sorafenib (0.59 [95% CrI 0.39–0.87]; 99%), SIRT (0.51 [95% CrI 0.32–0.82]; 100%), or placebo/best supportive care (0.40 [95% CrI 0.25–0.64]; 100%). Key Messages: Within the context of indirect comparisons, analyses of OS favored atezolizumab-bevacizumab versus other treatment options for patients with locally advanced or metastatic unresectable HCC.
Nerve Fibers in the Tumor Microenvironment as a Novel Biomarker for Oncological Outcome in Patients Undergoing Surgery for Perihilar Cholangiocarcinoma
Authors: Bednarsch Jan , Kather Jakob , Tan Xiuxiang , Sivakumar Shivan , Cacchi Claudio , Wiltberger Georg , Czigany Zoltan , Ulmer Florian , Neumann Ulf Peter , Heij Lara Rosaline
Published: May 2021

Introduction: Perihilar cholangiocarcinoma (pCCA) is a biliary tract cancer with a dismal prognosis, with surgery being the only chance of cure. A characteristic aggressive biological feature of pCCA is perineural growth which is defined by the invasion of cancer cells to nerves and nerve fibers. Recently, nerve fiber density (NFD) was linked to oncological outcomes in various malignancies; however, its prognostic role in pCCA remains to be elucidated. Materials and Methods: Data of 101 pCCA patients who underwent curative-intent surgery between 2010 and 2019 were included in this study. Extensive group comparisons between patients with high and low NFD were carried out, and the association of cancer-specific survival (CSS) and recurrence-free survival with NFD and other clinicopathological characteristics was assessed using univariate and multivariable cox regression models. Results: Patients with high NFD showed a median CSS of 90 months (95% CI: 48–132, 3-year CSS = 77%, 5-year CSS = 72%) compared to 33 months (95% CI: 19–47, 3-year CSS = 46%, 5-year CSS = 32%) in patients with low NFD (p = 0.006 log rank). Further, N1 category (HR = 2.84, p = 0.001) and high NFD (HR = 0.41, p = 0.024) were identified as independent predictors of CSS in multivariable analysis. Patients with high NFD and negative lymph nodes showed a median CSS of 90 months (3-year CSS = 88%, 5-year CSS = 80%), while patients with either positive lymph nodes or low NFD displayed a median CSS of 51 months (3-year CSS = 59%, 5-year CSS = 45%) and patients with both positive lymph nodes and low NFD a median CSS of 24 months (3-year CSS = 26%, 5-year CSS = 16%, p = 0.001 log rank). Conclusion: NFD has been identified as an important novel prognostic biomarker in pCCA patients. NFD alone and in combination with nodal status in particular allows to stratify pCCA patients based on their risk for inferior oncological outcomes after curative-intent surgery.
Urachal Pathology: Review of Cases
Authors: García García Lorena , Ballesta Begoña , Rodríguez Talavera Jonathan , Morales Orribo Nuria , Carrión Almudena
Published: May 2021

Introduction: The urachus is an embryologic remnant which is formed from the obliteration of the allantois. Urachal abnormalities are caused when defective obliteration of the urachus happens. They are an infrequent condition. Incidence is estimated to be between 5,000 and 8,000 live births. Its diagnosis and management remain a challenge due to the lack of an specific clinical picture and the controversy about the management. Objective: The objective of this study is to assess the clinical presentation, diagnosis, therapeutic management, and outcomes of urachal anomalies in our health area. Materials and Methods: We performed a retrospective review of all cases of urachal anomalies recorded Tenerife (southern health area), La Gomera, and El Hierro Islands during a 5 year period. Results: Twenty-three cases of urachal pathology were included. The mean age of presentation was 32 years old. 73.9% were male. 65% were diagnosed in adults. In 30.3% of the cases, it was a casual finding. Symptoms included fever, umbilical exudate, hematuria, abdominal pain, and umbilical granuloma. The main diagnostic tests were ultrasound and computed tomography scan. Treatments were selected conservative management (43.5%), selective resection, partial cystectomy, and radical cystectomy. All patients had a good evolution. However, 2 cases where benign tumors were suspected, clinically, had a final histology of cancer in the specimen. Conclusions: Due to the lack of a specific clinical picture and undefined findings in image tools, diagnosis is difficult and it may be inaccurate. Despite more data are needed, our results suggest that the systematic excision of urachal lesions could result in safer outcomes since cases where a benign lesion is clinically suspected might result in malignant tumors.
The Emerging Role of Circular RNAs in Cerebral Vascular Disorders
Authors: Liu Wei , Yan Gao
Published: May 2021

Background: Circular RNAs (circRNAs) are covalently closed circular noncoding RNAs that are expressed in various life forms. CircRNAs have many characteristics, such as structural stability and tissue-specific expression that contribute to their role as a microRNA (sponge in gene regulation. Summary: Recent evidence suggests that circRNAs play an important role in the pathogenesis of cerebrovascular diseases (CVDs); however, the exact mechanism remains controversial. CircRNAs that are related to CVDs have great clinical significance. Key Messages: The present review provides an overview of the general biology of circRNAs, their relevant regulatory mechanisms, and their role in the pathophysiology of CVDs.
Impact of Sleep Duration on Mortality and Quality of Life in Chronic Kidney Disease: Results from the 2007–2015 KNHANES
Authors: Lee Hyo Jin , Kwak Nakwon , Kim Yong Chul , Choi Sun Mi , Lee Jinwoo , Park Young Sik , Lee Chang-Hoon , Lee Sang-Min , Yoo Chul-Gyu , Cho Jaeyoung
Published: May 2021

Introduction: In the general population, short and long sleep durations have been associated with adverse health outcomes. However, this association remains unclear in patients with chronic kidney disease (CKD). We examined the relationship of sleep duration to mortality and health-related quality of life (HRQOL) in individuals with CKD. Methods: A total of 1,783 adults with CKD who participated in the 2007–2015 Korea National Health and Nutrition Examination Survey were analyzed. CKD was defined as an estimated glomerular filtration rate of <60 mL/min per 1.73 m2. Participants were categorized into 3 groups according to self-reported sleep duration: <6 h (short sleepers), 6–8 h, and >8 h (long sleepers). The outcome variables were all-cause mortality and HRQOL. HRQOL was assessed using the European Quality of Life-5 Dimensions (EQ-5D) index. Results: During a median of 6.4 years, 481 (27%) deaths occurred. In unadjusted Cox regression analysis, long sleepers with CKD had an increased risk of death (hazard ratio [HR], 1.62; 95% confidence interval [CI]: 1.26–2.09). This significant association remained after adjusting for age, sex, and BMI (HR, 1.36; 95% CI: 1.05–1.75); however, it was lost after adjusting for CKD stage, social and lifestyle factors, and presence of comorbidities (HR, 1.15; 95% CI: 0.89–1.49). Compared with 6- to 8-h sleepers with CKD, long sleepers with CKD had significantly worse HRQOL in multivariable linear regression models. The adjusted means of the EQ-5D index were 0.80 (95% CI: 0.77–0.82) for short sleepers, 0.81 (95% CI: 0.80–0.82) for 6- to 8-h sleepers, and 0.76 (95% CI: 0.73–0.79) for long sleepers (p = 0.01). Discussion/Conclusion: Long sleep duration is associated with poor HRQOL in Korean adults with CKD. The weak association between long sleep duration and mortality was attenuated after multivariable adjustment in this study.
Consanguinizar y Afinizar. La domesticación de los animales, las plantas y los humanos en las acciones de desarrollo
Authors: Schiavoni Gabriela
Published: May 2021

Este artículo versa sobre las formas de familiarización entre los pequeños agricultores y las especies comestibles. Las acciones de desarrollo orientadas a la producción de alimentos intervienen controlando la propagación de animales y plantas y la replicación de relaciones entre los humanos. Nuestro artículo describe las transformaciones del flujo de consanguinidad entre los humanos y las especies alimenticias, a través de la diferenciación de líneas, codificadas por el género, que plantean una oposición entre los sexos. La relación de contrapartes solicitada por los colectivos de desarrollo (cooperativas, asociaciones) suspende la consanguinización de las alianzas y los vínculos políticos y económicos se abren paso a través de los lazos de afinidad. La investigación etnográfica que sustenta esta contribución se llevó a cabo entre los pequeños agricultores del nordeste de Misiones (Argentina), las Ongs y los programas estatales que incentivan la producción de alimentos en las últimas décadas del siglo XX.
O Cinema em Gilles Deleuze: apontamentos sobre a imagem-movimento
Authors: Fialho Ana Luísa Coutinho
Published: May 2021

Em Cinema 1 – A Imagem-Movimento (1983), Deleuze constrói conceitos que tratam dos elementos fundamentais de sua filosofia a respeito do cinema, tendo como ponto de partida a análise bergsoniana do movimento, em A Evolução Criadora (1907), e da imagem, em Matéria e Memória (1896) . Bergson, que conviveu com o cinema em seus primórdios (final do séc. XIX e início do séc. XX), faz menção a ele com uma concepção muito avessa àquela que a filosofia deleuziana viria a ter — apesar disso, sua crítica à maneira pela qual construímos nossa noção de movimento acaba conectando-se diretamente ao cinema pós-montagem, fertilizando um solo riquíssimo de análises filosóficas acerca do cinema, que Deleuze aproveitou para a elaboração de suas obras sobre o tema. O objetivo desse artigo é fortalecer a ponte entre a metafísica bergsoniana e a filosofia do cinema de Deleuze no sentido de entender a maneira particular pela qual Deleuze apropria-se de conceitos metafísicos de Bergson. Para isso, utilizamos análise estrutural dos textos mencionados, comparando-os. No final desse processo pudemos observar as relações de sentido entre conceitos bergsonianos e os planos cinematográficos analisados por Deleuze.
Social Determinants of Adherence to COVID-19 Risk Mitigation Measures Among Adults With Cardiovascular Disease
Authors: Hagan Kobina K. , Javed Zulqarnain , Cainzos-Achirica Miguel , Sostman Dirk , Vahidy Farhaan S. , Valero-Elizondo Javier , Acquah Isaac , Yahya Tamer , Kash Bita , Andrieni Julia D. , Dubey Prachi , Hyder Adnan A. , Nasir Khurram
Published: May 2021

Background:

Social determinants of health (SDOH) may limit the practice of coronavirus disease 2019 (COVID-19) risk mitigation guidelines with health implications for individuals with underlying cardiovascular disease (CVD). Population-based evidence of the association between SDOH and practicing such mitigation strategies in adults with CVD is lacking. We used the National Opinion Research Center’s COVID-19 Household Impact Survey conducted between April and June 2020 to evaluate sociodemographic disparities in adherence to COVID-19 risk mitigation measures in a sample of respondents with underlying CVD representing 18 geographic areas of the United States.

Methods:

CVD status was ascertained by self-reported history of receiving heart disease, heart attack, or stroke diagnosis. We built de novo, a cumulative index of SDOH burden using education, insurance, economic stability, 30-day food security, urbanicity, neighborhood quality, and integration. We described the practice of measures under the broad strategies of personal protection (mask, hand hygiene, and physical distancing), social distancing (avoiding crowds, restaurants, social activities, and high-risk contact), and work flexibility (work from home, canceling/postponing work). We reported prevalence ratios and 95% CIs for the association between SDOH burden (quartiles of cumulative indices) and practicing these measures adjusting for age, sex, race/ethnicity, comorbidity, and interview wave.

Results:

Two thousand thirty-six of 25 269 (7.0%) adults, representing 8.69 million in 18 geographic areas of the United States, reported underlying CVD. Compared with the least SDOH burden, fewer individuals with the greatest SDOH burden practiced all personal protection (75.6% versus 89.0%) and social distancing measures (41.9% versus 58.9%) and had any flexible work schedule (26.2% versus 41.4%). These associations remained statistically significant after full adjustment: personal protection (prevalence ratio, 0.83 [95% CI, 0.73–0.96];
P
=0.009), social distancing (prevalence ratio, 0.69 [95% CI, 0.51–0.94];
P
=0.018), and work flexibility (prevalence ratio, 0.53 [95% CI, 0.36–0.79];
P
=0.002).

Conclusions:

SDOH burden is associated with lower COVID-19 risk mitigation practices in the CVD population. Identifying and prioritizing individuals whose medical vulnerability is compounded by social adversity may optimize emerging preventive efforts, including vaccination guidelines.
Additive Effect of Coexisting Aneurysms Increases Subarachnoid Hemorrhage Risk in Patients With Multiple Aneurysms
Authors: Feng Xin , Tong Xin , Peng Fei , Niu Hao , Qi Peng , Lu Jun , Zhao Yang , Jin Weitao , Wu Zhongxue , Liu He , Zhao Yuanli , Liu Aihua , Wang Daming
Published: May 2021

Background and Purpose:

It remains unclear whether the additive effect of coexisting intracranial aneurysms increases the risk of subarachnoid hemorrhage (SAH) in patients with multiple intracranial aneurysms. We have performed a tentative analysis for the additive effect of coexisting aneurysms.

Methods:

This multi-institutional cross-sectional study included 1781 aneurysms from 746 patients with multiple intracranial aneurysms. Using the generalized linear mixed model, we analyzed risk factors associated with individual aneurysm rupture and assessed the additive risk of SAH for each patient.

Results:

The coexisting aneurysms number was not significantly associated with individual intracranial aneurysm rupture, both in unadjusted and adjusted analyses. Patient-level analysis found that an increased number of coexisting aneurysms was significantly associated with a greater estimated additive risk (
P
<0.001). Estimated additive risks of patients with 2, 3, and 4 or more coexisting intracranial aneurysms were 25.9%, 31.8%, and 38.1%, respectively, which are comparable to the actual incidence of SAH in those patients (26.6%, 29.5%, and 36.5%, respectively), with a Spearman correlation coefficient of 1.000 (
P
<0.001). Compared with aneurysm-related factors, the estimated additive effect had better discrimination power for SAH risk, with areas under the receiver operating characteristic curve of 0.821.

Conclusions:

We found that a greater number of coexisting aneurysms did not increase rupture risk of individual aneurysms, but the potential additive effect might increase SAH risk in patients with multiple intracranial aneurysms.
An analysis of form and function of a research article between and within publishers and journals
Authors: Nathan Sarah , Haynes Leah , Meyer Jessica , Sumner Josh , Hudson-Vitale Cynthia , McIntosh Leslie D.
Published: May 2021

The identification and subsequent analysis of research articles for machine learning and natural language processing is a complicated task given the lack of consistent article organization principles and heading naming conventions across publishers and journals. Given this, an understanding of how research articles organizationally follow a common function and their use of various heading terms, or forms, is a critical step in applying machine learning techniques for data and information mining across a corpus of articles. To address this need, the authors developed and implemented an article heading form and function analysis across 12 publishers including both research articles and nonresearch articles. Our aim was to (a) identify each of the labeled sections used by research articles, define these sections based on their rhetorical function, and determine frequency of use; (b) within the given data set, determine all of the alternative labels used to identify these sections; and (c) determine whether these sections can be used to consistently determine (1) whether an article is a true research article, or (2) whether an article is not a research article. The results indicated wide variability in the organization of research articles with 24 common sections, known by 186 different names both within and across publishing houses.
A propos de la racine להם dans Proverbes 18:8
Authors: Masson Michel
Published: May 2021

This note proposes to interpret the global meaning of the root להם as “to devour” and, as a consequence, to understand Prov 18:8 as “the plotter’s words gnaw at his victim’s guts.”
The Meaning and Syntax of taʿărōg
Authors: Nathan Jonathan
Published: May 2021

The word taʿărōg, which appears three times in the Hebrew Bible, has been traditionally interpreted as a third-person feminine form. This article proposes that it instead be treated as a second-person masculine form, and that the two verses in which it appears be re-analysed accordingly.
Die Handelsgüter der Tarsis-Schiffe (1Kön 10,22): Ein Vergleich zwischen Masoretischem Text und Septuaginta
Authors: Albrecht Felix
Published: May 2021

This article examines 1 Kgs/3 Kgdms 10:22 (par. 2 Chr 9:21) by the comparison of MT and LXX and provides a reconstruction of the Hebrew Vorlage of 3 Kgdms 10:22.
Baptism and the Munus Triplex
Authors: Otto Randall E.
Published: May 2021

The munus triplex, or threefold office of Christ, has been a standard Reformed means of delineating the work of Christ as prophet, priest, and king. This article develops the significance of the offices for Christian participation in Christ’s work through baptism. Baptism includes identification with and submission to God’s Word, anointing with God’s Spirit, and confirmation as God’s son. Each of these three aspects of baptism may be subsumed under the threefold office of Christ to include those who ‘share in Christ and thus in his anointing’ through baptism as prophet, priest, and king. While Jesus’ baptism uniquely served to identify him with God’s Word and submission to it as a prophet, to anoint him with God’s Spirit as a priest, and to confirm him as God’s Son and thus king, the Christian shares in each of these callings by means of baptism.
First record of the genus Yalvaciana (Tettigoniidae; Tettigoniinae; Platycleidini) with the description of a new species from India
Authors: SHAH MUZAMIL SYED , USMANI MOHD KAMIL
Published: May 2021

The genus Yalvaciana Ciplak et.al (2002) is reported for the first time from India represented by a new species. Previously the genus comprised a single species, Yalvaciana yalvaci Demirsoy, (1974). Brief information about morphology, distribution and key to species are given. The Holotype has been deposited in the Museum of Zoology Department, AMU (ZDAMU).
Improving the Analysis and Forecast of Hurricane Dorian (2019) with Simultaneous Assimilation of GOES-16 All-Sky Infrared Brightness Temperatures and Tail Doppler Radar Radial Velocities
Authors: Hartman Christopher M. , Chen Xingchao , Clothiaux Eugene E. , Chan Man-Yau
Published: May 2021

Recent studies have shown that the assimilation of all-sky infrared (IR) observations can be beneficial for tropical cyclone analyses and predictions. The assimilation of Tail Doppler Radar (TDR) radial velocity observations has also been shown to improve tropical cyclone analyses and predictions; however, there is a paucity of literature on the impacts of simultaneously assimilating them with all-sky infrared IR brightness temperatures (BTs). This study examines the impacts of assimilating combinations of GOES-16 all-sky IR brightness temperatures, NOAA P-3 TDR radial velocities, and conventional observations from the Global Telecommunications System (GTS) on the analyses and forecasts of Hurricane Dorian (2019). It is shown that including IR and/or TDR observations on top of conventional GTS observations significantly reduces both track and intensity forecast errors. Track errors are reduced the most (25% at lead times greater than 48 h) when TDR and GTS observations are assimilated. In terms of intensity, errors are always lower at lead times greater than 48 h when IR BTs are assimilated. Simultaneously assimilating TDR and IR observations has the potential to further improve the intensity forecast by as much as 37% at a lead time of 48 h to 72 h. The improved intensity forecasts produced by the experiments assimilating all three observation sources are shown to be a result of the competing effects of IR assimilation producing an overly broad area of strong cyclonic circulation and TDR assimilation constraining that circulation to a more realistic size and intensity. Interestingly, the order in which observations are assimilated has non-negligible impacts on the analyses and forecasts of Dorian.
Comprehensive CRISPR-Cas9 screens identify genetic determinants of drug responsiveness in multiple myeloma
Authors: Bohl Stephan R. , Schmalbrock Laura K. , Bauhuf Imke , Meyer Tatjana , Dolnik Anna , Szyska Martin , Blätte Tamara J. , Knödler Sarah , Röhner Linda , Miller Denise , Kull Miriam , Langer Christian , Döhner Hartmut , Letai Anthony , Damm Frederik , Heckl Dirk , Bullinger Lars , Krönke Jan
Published: May 2021

The introduction of new drugs in the past years has substantially improved outcome in multiple myeloma (MM). However, the majority of patients eventually relapse and become resistant to one or multiple drugs. While the genetic landscape of relapsed/ resistant multiple myeloma has been elucidated, the causal relationship between relapse-specific gene mutations and the sensitivity to a given drug in MM has not systematically been evaluated. To determine the functional impact of gene mutations, we performed combined whole-exome sequencing (WES) of longitudinal patient samples with CRISPR-Cas9 drug resistance screens for lenalidomide, bortezomib, dexamethasone, and melphalan. WES of longitudinal samples from 16 MM patients identified a large number of mutations in each patient that were newly acquired or evolved from a small subclone (median 9, range 1-55), including recurrent mutations in TP53, DNAH5, and WSCD2. Focused CRISPR-Cas9 resistance screens against 170 relapse-specific mutations functionally linked 15 of them to drug resistance. These included cereblon E3 ligase complex members for lenalidomide, structural genes PCDHA5 and ANKMY2 for dexamethasone, RB1 and CDK2NC for bortezomib, and TP53 for melphalan. In contrast, inactivation of genes involved in the DNA damage repair pathway, including ATM, FANCA, RAD54B, and BRCC3, enhanced susceptibility to cytotoxic chemotherapy. Resistance patterns were highly drug specific with low overlap and highly correlated with the treatment-dependent clonal evolution in patients. The functional association of specific genetic alterations with drug sensitivity will help to personalize treatment of MM in the future.
Achromobacter xylosoxidansairway infection is associated with lung disease severity in children with cystic fibrosis
Authors: Marsac Charlotte , Berdah Laura , Thouvenin Guillaume , Sermet-Gaudelus Isabelle , Corvol Harriet
Published: May 2021

Background

Despite the increasing prevalence ofAchromobacter xylosoxidanslung infection in patients with cystic fibrosis (CF), its clinical pathogenicity remains controversial. The objective of this study was to evaluate the effects of this emerging bacterium on lung disease severity in CF children.

Methods

This case–control retrospective study took place in two French paediatric CF centres. 45 cases infected byA. xylosoxidanswere matched for age, sex,CFTRgenotypes and pancreatic status to 45 never-infected controls. Clinical data were retrieved from clinical records over the 2 years before and afterA. xylosoxidansinitial infection.

Results

At infection onset, lung function was lower in cases compared with controls (p=0.006). Over the 2 years prior toA. xylosoxidansacquisition, compared with controls, cases had more frequent pulmonary exacerbations (p=0.02), hospitalisations (p=0.05), and intravenous (p=0.03) and oral (p=0.001) antibiotic courses. In the 2 years followingA. xylosoxidansinfection, cases remained more severe with more frequent pulmonary exacerbations (p=0.0001), hospitalisations (p=0.0001), and intravenous (p=0.0001) and oral antibiotic courses (p=0.0001). Lung function decline tended to be faster in cases (−5.5% per year) compared with controls (−0.5% per year).

Conclusions

This case–control study demonstrates thatA. xylosoxidansoccurs more frequently in the patients with the worse lung disease. Further studies assessing the pathogenicity of this emerging pathogen and international treatment recommendations are warranted.
Emergency medical dispatcher training as a strategy to improve pre-hospital care in low- and middle-income countries: the case study of Nepal
Authors: Jacobson Claire L. , Basnet Samjhana , Bhatt Ajay , Parajuli Shreejesh , Shrestha Sanu Krishna
Published: May 2021

Background

Low- and middle-income countries (LMICs) often face significant challenges related to providing effective pre-hospital care services. Barriers to providing care include lack of financial resources, poor road infrastructure, lack of trained first responders and ambulance staff, and issues regarding coordination/communication between different entities involved in Emergency Medical Services. Prior initiatives to characterize and improve the state of pre-hospital care in LMICs have largely focused on improving access to high-quality ambulance services by providing training programs to community first responders and ambulance staff on how to recognize and manage key emergency conditions. In this article, we discuss an alternative strategy for improving pre-hospital care: the creation of a context-specific Emergency Medical Dispatcher (EMD) training curriculum and program.

Methods

We describe the current pre-hospital care setting in Nepal, the process of creating and piloting the Nepal-specific EMD training manual, and the early impact of its implementation.

Results

The 30-h EMD training was designed, piloted, and revised in collaboration with the three largest EMS organizations in Nepal. The training is now required for all dispatchers at the Dhulikhel Hospital Dispatch Center, one of the largest ambulance dispatch networks in Nepal. Dispatchers are trained in the following knowledge and skill areas: telecommunication guidelines, triaging and documentation procedures, delivery of Basic Life Support instructions to callers, other medical and trauma-condition specific instructions, and limited resource management. The short-term positive impacts of the training’s implementation include improved documentation procedures, better prioritization of ambulance resources, delivery of Basic Life Support instructions to callers, and improved communication between dispatch, responders, and healthcare facilities.

Conclusions

Context-specific Emergency Medical Dispatch training programs, which aim to optimize the emergency resources available in resource-limited settings, present a promising low-cost, high-impact interventional strategy to strengthen the pre-hospital care systems in low- and middle-income countries.
Assessment of trade-offs between feed efficiency, growth-related traits, and immune activity in experimental lines of layer chickens
Authors: Zerjal Tatiana , Härtle Sonja , Gourichon David , Guillory Vanaïque , Bruneau Nicolas , Laloë Denis , Pinard-van der Laan Marie-Hélène , Trapp Sascha , Bed’hom Bertrand , Quéré Pascale
Published: May 2021

Background

In all organisms, life-history traits are constrained by trade-offs, which may represent physiological limitations or be related to energy resource management. To detect trade-offs within a population, one promising approach is the use of artificial selection, because intensive selection on one trait can induce unplanned changes in others. In chickens, the breeding industry has achieved remarkable genetic progress in production and feed efficiency over the last 60 years. However, this may have been accomplished at the expense of other important biological functions, such as immunity. In the present study, we used three experimental lines of layer chicken—two that have been divergently selected for feed efficiency and one that has been selected for increased antibody response to inactivated Newcastle disease virus (ND3)—to explore the impact of improved feed efficiency on animals’ immunocompetence and, vice versa, the impact of improved antibody response on animals’ growth and feed efficiency.

Results

There were detectable differences between the low (R+) and high (R−) feed-efficiency lines with respect to vaccine-specific antibody responses and counts of monocytes, heterophils, and/or T cell population. The ND3 line presented reduced body weight and feed intake compared to the control line. ND3 chickens also demonstrated an improved antibody response against a set of commercial viral vaccines, but lower blood leucocyte counts.

Conclusions

This study demonstrates the value of using experimental chicken lines that are divergently selected for RFI or for a high antibody production, to investigate the modulation of immune parameters in relation to growth and feed efficiency. Our results provide further evidence that long-term selection for the improvement of one trait may have consequences on other important biological functions. Hence, strategies to ensure optimal trade-offs among competing functions will ultimately be required in multi-trait selection programs in livestock.
Application of machine learning in predicting hospital readmissions: a scoping review of the literature
Authors: Huang Yinan , Talwar Ashna , Chatterjee Satabdi , Aparasu Rajender R.
Published: May 2021

Background

Advances in machine learning (ML) provide great opportunities in the prediction of hospital readmission. This review synthesizes the literature on ML methods and their performance for predicting hospital readmission in the US.

Methods

This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) Statement. The extraction of items was also guided by the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS). Electronic databases PUBMED, MEDLINE, and EMBASE were systematically searched from January 1, 2015, through December 10, 2019. The articles were imported into COVIDENCE online software for title/abstract screening and full-text eligibility. Observational studies using ML techniques for hospital readmissions among US patients were eligible for inclusion. Articles without a full text available in the English language were excluded. A qualitative synthesis included study characteristics, ML algorithms utilized, and model validation, and quantitative analysis assessed model performance. Model performances in terms of Area Under the Curve (AUC) were analyzed using R software. Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the reviewed studies.

Results

Of 522 citations reviewed, 43 studies met the inclusion criteria. A majority of the studies used electronic health records (24, 56%), followed by population-based data sources (15, 35%) and administrative claims data (4, 9%). The most common algorithms were tree-based methods (23, 53%), neural network (NN) (14, 33%), regularized logistic regression (12, 28%), and support vector machine (SVM) (10, 23%). Most of these studies (37, 85%) were of high quality. A majority of these studies (28, 65%) reported ML algorithms with an AUC above 0.70. There was a range of variability within AUC reported by these studies with a median of 0.68 (IQR: 0.64–0.76; range: 0.50–0.90).

Conclusions

The ML algorithms involving tree-based methods, NN, regularized logistic regression, and SVM are commonly used to predict hospital readmission in the US. Further research is needed to compare the performance of ML algorithms for hospital readmission prediction.
Primary tumor resection improves prognosis of unresectable carcinomas of the transverse colon including flexures with liver metastasis: a preliminary population-based analysis
Authors: Zhao Jiefeng , Zhu Jinfeng , Sun Rui , Huang Chao , Yuan Rongfa , Zhu Zhengming
Published: May 2021

Purpose

Studies on unresectable colorectal cancer liver metastasis(CRLM) rarely analyze the prognosis of the patients from the point of colonic subsites. We aimed to evaluate the effect of primary tumor resection (PTR) and different scope of colectomy on the prognosis of patients with unresectable transverse colon cancer liver metastasis (UTCLM), hepatic flexure cancer liver metastasis (UHFLM), and splenic flexure cancer liver metastasis (USFLM).

Patients and methods

The patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Cox proportional hazards regression models were used to identify prognostic factors of overall survival (OS) and cause-specific survival (CSS). Kaplan-Meier analyses and log-rank tests were conducted to assess the effectiveness of PTR on survival.

Results

In total, this study included a cohort of 1960 patients: 556 cases of UHFLM, 1008 cases of UTCLM, and 396 cases of USFLM. The median survival time of whole patients was 11.0 months, ranging from 7.0 months for UHFLM patients to 15.0 months for USFLM patients. USFLM patients had the best OS and CSS, followed by UTCLM patients. UHFLM patients had the worst OS and CSS (All P < 0.001). PTR could improve the OS and CSS of UTCLM, UHFLM, and USFLM (All P < 0.001). Subgroups analysis revealed that USFLM patients with tumor size≤5 cm and negative CEA had not demonstrated an improved OS and CSS after PTR. Multivariate analysis showed that PTR and perioperative chemotherapy were common independent prognostic factors for UHFLM, UTCLM, and USFLM patients. There was no difference between segmental colon resection and larger colon resection on CSS of UHFLM, UTCLM, and USFLM patients.

Conclusions

We confirmed the different survival of patients with UTCLM, UHFLM, and USFLM, and for the first time, we proved that PTR could provide survival benefits for patients with unresectable CRLM from the perspective of colonic subsites of transverse colon, hepatic flexure, and splenic flexure. Besides, PTR may not improve the prognosis of USFLM patients with CEA- negative or tumor size≤5 cm. For oncologic outcomes, we concluded that segmental colon resection seemed an effective surgical procedure for UTCLM, UHFLM, and USFLM.
Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees
Authors: Kallings Lena V. , Blom Victoria , Ekblom Björn , Holmlund Tobias , Eriksson Jane Salier , Andersson Gunnar , Wallin Peter , Ekblom-Bak Elin
Published: May 2021

Background

Total sitting time is associated with a higher risk for cardio metabolic disease and mortality, while breaks in prolonged sitting attenuate these effects. However, less is known about associations of different specific domains and breaks of sitting on general health, back/neck pain and if physical activity could influence these associations. The aim was to investigate how workplace sitting and frequency of breaking up workplace sitting is associated with self-reported general health and self-reported back/neck pain.

Methods

44,978 participants (42% women) from the Swedish working population, who participated in a nationwide occupational health service screening 2014–2019, were included in this cross-sectional study. Self-reported sitting duration and frequency of breaks from sitting at work, general health, back/neck pain, exercise, leisure time sitting, diet, smoking, stress and body mass index were assessed. Occupation was classified as requiring higher education qualifications or not. Logistic regression modelling was used to assess the association between workplace sitting/frequency of breaks in workplace sitting and poor general health and back/neck pain, respectively.

Results

Compared to sitting all the time at work, sitting ≤75% of the time showed significantly lower risks for poor general health (OR range 0.50–0.65), and sitting between 25 and 75% of the time showed significantly lower risks (OR 0.82–0.87) for often reported back/neck pain. For participants reporting sitting half of their working time or more, breaking up workplace sitting occasionally or more often showed significantly lower OR than seldom breaking up workplace sitting; OR ranged 0.40–0.50 for poor health and 0.74–0.81 for back/neck pain.

Conclusions

Sitting almost all the time at work and not taking breaks is associated with an increased risk for self-reported poor general health and back/neck pain. People sitting almost all their time at work are recommended to take breaks from prolonged sitting, exercise regularly and decrease their leisure time sitting to reduce the risk for poor health.
Effects of a school-based physical activity intervention on academic performance in 14-year old adolescents: a cluster randomized controlled trial – the School in Motion study
Authors: Solberg Runar Barstad , Steene-Johannessen Jostein , Anderssen Sigmund Alfred , Ekelund Ulf , Säfvenbom Reidar , Haugen Tommy , Berntsen Sveinung , Åvitsland Andreas , Lerum Øystein , Resaland Geir Kåre , Kolle Elin
Published: May 2021

Background

School-based physical activity interventions evaluating the effect on academic performance usually includes children. We aimed to investigate the effect of a nine-month, school-based physical activity intervention titled School in Motion (ScIM) on academic performance in adolescents.

Methods

Thirty secondary schools in Norway were cluster-randomized into three groups: the Physically active learning (PAL) group (n = 10), the Don’t worry – Be Happy (DWBH) group (n = 10) or control (n = 10). Target dose in both intervention groups was 120 min/week of additional PA during school hours. Parental consent was obtained from 2084 adolescent students (76%). Standardized national tests in reading and numeracy was conducted at baseline and at the end of the intervention. We used linear mixed model to test intervention effects. We found significant intervention effects in numeracy and reading among students in both interventions when compared with controls.

Results

The mean difference in change in numeracy was 1.7 (95% CI: 0.9 to 2.5; Cohen’s d = 0.12) and 2.0 (95% CI: 1.4 to 2.7; Cohen’s d = 0.23) points in favour of students in the PAL and DWBH intervention, respectively. Similar results were found for reading, where the mean difference in change was 0.9 (95% CI 0.2 to 1.6; Cohen’s d = 0.06) and 1.1 (95% CI 0.3 to 1.9; Cohen’s d = 0.18) points in favour of students in the PAL and DWBH intervention, respectively. When conducting intention to treat analysis with imputed data the estimates were attenuated and some no longer significant.

Conclusion

The ScIM study demonstrates that two different school-based PA interventions providing approximately 120 min of additional PA weekly over nine months, significantly improved numeracy and reading performance in 14-year old students compared with controls. However, the results should be interpreted with caution as the effect sizes reported were very small or small and the estimates were attenuated when conducting intention to treat analysis. Despite this, our results are still positive and suggest that PA interventions are viable models to increase academic performance among adolescents.

Trial registration

Retrospectively registered (25/01/2019): NCT03817047.
Evaluation of the first annular pulley stretch effect under isometric contraction of the flexor tendon in healthy volunteers and trigger finger patients using ultrasonography
Authors: Tanaka Shinya , Uehara Kosuke , Sugimura Ryota , Miura Toshiki , Ohe Takashi , Tanaka Sakae , Morizaki Yutaka
Published: May 2021

Background

Isometric exercises for a flexed finger have been reported to be effective for treating trigger finger as the flexor tendon widens the space under the first annular (A1) pulley towards the palmar destination during the exercise. This study aimed to evaluate the structural changes during the A1 pulley stretch in healthy volunteers and patients with trigger finger using ultrasonography.

Methods

We enrolled 25 male and 14 female patients (39 middle fingers). The thickness of the subcutaneous tissue (parameter a), A1 pulley (parameter b), and the flexor tendon (parameter c) and the distance between the dorsal surface of the flexor tendon and the palmar surface of the metacarpal head (parameter d) were measured using ultrasonography of the metacarpophalangeal joint of the middle finger flexed at 45° at rest (pattern A) and under isometric contraction of the flexor tendon against an extension force of the proximal interphalangeal joint (pattern B).

Results

The average differences between patterns A and B in the healthy volunteers were 0.29 mm (parameter a; P = 0.02), 0.017 mm (parameter b; P = 0.63), 0.16 (parameter c; P = 0.26), and 0.41 (parameter d; P = 0.004), and those in patients with trigger finger were 0.22 mm (parameter a; P = 0.23), 0.019 mm (parameter b; P = 0.85), 0.03 mm (parameter c; P = 0.82), and 0.78 mm (parameter d; P < 0.001). The distance between the dorsal side of the A1 pulley and the palmar surface of the metacarpal head was also significantly increased by 0.57 mm (8.2%) in healthy volunteers (P < 0.001) and 0.81 mm (11%) in patients with trigger finger (P < 0.001).

Conclusions

In this study, the space under the A1 pulley was expanded under isometric contraction of the flexor tendon. These findings support the effectiveness of pulley stretch exercises for the trigger finger condition.
The effects of topical erythropoietin on non-surgical treatment of periodontitis: a preliminary study
Authors: Aslroosta Hoori , Yaghobee Siamak , Akbari Solmaz , Kanounisabet Negar
Published: May 2021

Background

The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment.

Methods

This study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non‐adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05.

Results

All clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P < 0.00). After the treatment, there was a significant greater reduction in CAL and also PD values in test group (P < 0.01).

Conclusion

Local application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis.

Trial registration: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.