bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent advances of deep learning in psychiatric disorders
Authors: Chen Lu , Xia Chunchao , Sun Huaiqiang
Published: August 2020

Deep learning (DL) is a recently proposed subset of machine learning methods that has gained extensive attention in the academic world, breaking benchmark records in areas such as visual recognition and natural language processing. Different from conventional machine learning algorithm, DL is able to learn useful representations and features directly from raw data through hierarchical nonlinear transformations. Because of its ability to detect abstract and complex patterns, DL has been used in neuroimaging studies of psychiatric disorders, which are characterized by subtle and diffuse alterations. Here, we provide a brief review of recent advances and associated challenges in neuroimaging studies of DL applied to psychiatric disorders. The results of these studies indicate that DL could be a powerful tool in assisting the diagnosis of psychiatric diseases. We conclude our review by clarifying the main promises and challenges of DL application in psychiatric disorders, and possible directions for future research.
Mutual Fund Performance and Flows during the COVID-19 Crisis
Authors: Pástor Ľuboš , Vorsatz M Blair
Published: August 2020

We present a comprehensive analysis of the performance and flows of U.S. actively managed equity mutual funds during the 2020 COVID-19 crisis. We find that most active funds underperform passive benchmarks during the crisis, contradicting a popular hypothesis. Funds with high sustainability ratings perform well, as do funds with high star ratings. Fund outflows surpass precrisis trends, but not dramatically. Investors favor funds that apply exclusion criteria and funds with high sustainability ratings, especially environmental ones. Our finding that investors remain focused on sustainability during this major crisis suggests they view sustainability as a necessity rather than a luxury good.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Sleep-related head jerks: toward a new movement disorder
Authors: Lopez Régis , Chenini Sofiène , Barateau Lucie , Rassu Anna-Laura , Evangelista Elisa , Abril Beatriz , Fanielle Julien , Vitello Nicolas , Jaussent Isabelle , Dauvilliers Yves
Published: August 2020

Study Objectives

Sleep-related head jerks (SRHJ) are often considered as a physiological motor phenomenon, occurring mainly during rapid eye movement (REM) sleep. Their clinical relevance and links with other sleep parameters are unclear. We characterized the clinical and polysomnographic features of patients with excessive SRHJ and compare them with healthy controls and patients with isolated REM sleep behavior disorder (iRBD).

Methods

A total of 30 patients (19 males, 27.5 y.o., 16.0–51.0) with a REM-HJ index >30/h were identified over a period of 5 years. All had a video-polysomnographic (PSG) recording to characterize the SRHJ, to assess associations with other sleep parameters and to quantify phasic and tonic electromyographic activity during REM sleep, compared with 30 healthy controls and 30 patients with iRBD.

Results

Five among the 30 patients had a primary complaint of involuntary nighttime head movements associated with sleepiness or non-restorative sleep. The mean REM-HJ index was 57.22/h ± 24.42, a nonperiodic pattern, stable across the sleep cycles, and with a low between-test variability (for the nine patients with two PSG assessments in untreated condition). REM-HJs were often associated with arousals (65.2%) and leg movements (38.1%) and less with respiratory events (9.6%), without association with increased phasic and tonic electromyographic activities. SRHJ were also found in 36.7% of controls and 56.7% of iRBD patients, but with a lower index in REM sleep (0.79/h ± 1.59 and 2.76/h ± 4.57).

Conclusions

Although SRHJ are frequent in the general population and with uncertain clinical significance, rare severe symptomatic forms should be individualized and eventually be categorized as a new sleep-related movement disorder, distinct from RBD and periodic leg movements.
Dexmedetomidine-induced deep sedation mimics non-rapid eye movement stage 3 sleep: large-scale validation using machine learning
Authors: Ramaswamy Sowmya M , Weerink Maud A S , Struys Michel M R F , Nagaraj Sunil B
Published: August 2020

Study Objectives

Dexmedetomidine-induced electroencephalogram (EEG) patterns during deep sedation are comparable with natural sleep patterns. Using large-scale EEG recordings and machine learning techniques, we investigated whether dexmedetomidine-induced deep sedation indeed mimics natural sleep patterns.

Methods

We used EEG recordings from three sources in this study: 8,707 overnight sleep EEG and 30 dexmedetomidine clinical trial EEG. Dexmedetomidine-induced sedation levels were assessed using the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score. We extracted 22 spectral features from each EEG recording using a multitaper spectral estimation method. Elastic-net regularization method was used for feature selection. We compared the performance of several machine learning algorithms (logistic regression, support vector machine, and random forest), trained on individual sleep stages, to predict different levels of the MOAA/S sedation state.

Results

The random forest algorithm trained on non-rapid eye movement stage 3 (N3) predicted dexmedetomidine-induced deep sedation (MOAA/S = 0) with area under the receiver operator characteristics curve >0.8 outperforming other machine learning models. Power in the delta band (0–4 Hz) was selected as an important feature for prediction in addition to power in theta (4–8 Hz) and beta (16–30 Hz) bands.

Conclusions

Using a large-scale EEG data-driven approach and machine learning framework, we show that dexmedetomidine-induced deep sedation state mimics N3 sleep EEG patterns.

Clinical Trials

Name—Pharmacodynamic Interaction of REMI and DMED (PIRAD), URL—https://clinicaltrials.gov/ct2/show/NCT03143972, and registration—NCT03143972.
Neurophysiological and Psychological Consequences of Social Exclusion: The Effects of Cueing In-Group and Out-Group Status
Authors: Jenkins Michael , Obhi Sukhvinder S
Published: August 2020

Exclusion by outgroups is often attributed to external factors such as prejudice. Recently, event-related potential studies have demonstrated that subtle cues influence expectations of exclusion, altering the P3b response to inclusion or exclusion. We investigated whether a visual difference between participants and interaction partners could activate expectations of exclusion, indexed by P3b activity, and whether this difference would influence psychological responses to inclusion and exclusion. Participants played a ball-tossing game with two computer-controlled coplayers who were believed to be real. One period involved fair play inclusion while the other involved partial exclusion. Avatars represented participants, with their color matching participant skin tone, and either matching or differing from the color of coplayer avatars. This created the impression that the participant was an ingroup or outgroup member. While ingroup members elicited enhanced P3b activation when receiving the ball during exclusion, outgroup members showed this pattern for both inclusion and exclusion, suggesting that they formed robust a-priori expectations of exclusion. Self-reports indicated that while these expectations were psychologically protective during exclusion, they were detrimental during inclusion. Ultimately, this study reveals that expectations of exclusion can be formed purely based on visual group differences, regardless of the actual minority or majority status of individuals.
Fatal hyperprogression induced by nivolumab in metastatic renal cell carcinoma with sarcomatoid features: a case report
Authors: Dionese Michele , Pierantoni Francesco , Maruzzo Marco , Bimbatti Davide , Deppieri Filippo M. , Maran Michela , Gardiman Marina P. , Basso Umberto
Published: August 2020

In the past few years, the immune checkpoint inhibitor (ICI) nivolumab has become standard of care in the treatment of metastatic renal cell carcinoma (mRCC) progressing after antiangiogenic agents. To date, neither expression of programmed death ligand-1 (PD-L1) nor any other biomarker can be used to predict responses to ICIs, although intermediate–poor International Metastatic Database of Renal Carcinoma (IMDC) risk patients and those with sarcomatoid tumors appear to achieve superior benefit from immunotherapy. Paradoxically, ICIs may sometimes increase the speed of tumor growth. This rare phenomenon, called hyperprogression, has first been described in patients with melanoma and lung cancer treated with ICIs and is associated with poor survival. Here, we present the case of a patient affected by an intermediate IMDC risk mRCC with diffuse sarcomatoid features who achieved long disease control with first-line sunitinib and then started a second-line treatment with nivolumab. Unexpectedly, he experienced a dramatic acceleration of tumor growth and died soon after the third infusion of nivolumab. Then, we review the frequency of hyperprogression in mRCC and discuss the biological peculiarity of sarcomatoid RCC in terms of different responses to ICIs and antiangiogenic agents.
Lorlatinib for the treatment of inflammatory myofibroblastic tumour with TPM4-ALK fusion following failure of entrectinib
Authors: Wong Han Hsi , Bentley Helen , Bulusu Venkata Ramesh , Anyaegbu Gloria , Watkins James , Horan Gail , Hatcher Helen
Published: August 2020

Inflammatory myofibroblastic tumour (IMT) is a rare malignancy with limited responses to corticosteroids and chemotherapy. About half of cases have activating rearrangements in theALKgene which could be targeted with ALK inhibitors. A 40-year-old man presented with a large right lung mass and nodal, trapezius and cerebral metastases. Biopsy confirmed IMT withTPM4-ALKfusion. He was treated with prednisolone without clinical benefit. He received the Trk/ROS1/ALK inhibitor entrectinib in a clinical trial but his disease progressed in less than 3 months. Ifosfamide and etoposide in addition to radiotherapy to the brain and chest were administered. Transient improvement in the radiotherapy-treated areas was observed but his disease progressed shortly afterwards on all sites including the development of new adrenal metastasis. Compassionate use of the third-generation ALK inhibitor lorlatinib resulted in excellent partial response on all disease sites after 2 months, followed by a further 6 months of disease stabilisation. Repeat imaging showed slight increase in size of the cerebral metastasis but stable disease elsewhere, for which he was given stereotactic radiotherapy. His disease progressed 3 months later and lorlatinib was substituted with another ALK inhibitor brigatinib but he deteriorated and died shortly afterwards. Our patient tolerated lorlatinib well for 11 months with minimal toxicities, although he developed unilateral right-sided lung consolidation that was probably related to a combination of infection, radiotherapy and lorlatinib, which needed treatment with antibiotics and corticosteroids. This case demonstrates a role of lorlatinib in the treatment ofTPM4-ALK-rearranged IMT despite failure of entrectinib.
Organoid Models of Colorectal Pathology: Do They Hold the Key to Personalized Medicine? A Systematic Review
Authors: DeHaan Reece K. , Sarvestani Samaneh K. , Huang Emina H.
Published: August 2020

BACKGROUND:

Colorectal cancer and IBD account for a large portion of the practice of colorectal surgery. Historical research models have provided insights into the underlying causes of these diseases but come with many limitations.

OBJECTIVE:

The aim of this study was to systematically review the literature regarding the advantage of organoid models in modeling benign and malignant colorectal pathology.

DATA SOURCES:

Sources included PubMed, Ovid-Medline, and Ovid Embase

STUDY SELECTION:

Two reviewers completed a systematic review of the literature between January 2006 and January of 2020 for studies related to colon and intestinal organoids. Reviews, commentaries, protocols, and studies not performed in humans or mice were excluded.

RESULTS:

A total of 73 articles were included. Organoid models of colorectal disease have been rising in popularity to further elucidate the genetic, transcriptomic, and treatment response of these diseases at the individual level. Increasingly complex models utilizing coculture techniques are being rapidly developed that allow in vitro recapitulation of the disease microenvironment.

LIMITATIONS:

This review is only qualitative, and the lack of well utilized nomenclature in the organoid community may have resulted in the exclusion of articles.

CONCLUSIONS:

Historical disease models including cell lines, patient-derived tumor xenografts, and animal models have created a strong foundation for our understanding of colorectal pathology. Recent advances in 3-dimensional cell cultures, in the form of patient-derived epithelial organoids and induced human intestinal organoids have opened a new avenue for high-resolution analysis of pathology at the level of an individual patient. Recent research has shown the potential of organoids as a tool for personalized medicine with their ability to retain patient characteristics, including treatment response.
The Association of Saliva Cytokines and Pediatric Sports-Related Concussion Outcomes
Authors: Seeger Trevor A. , Tabor Jason , Sick Stacy , Schneider Kathryn J. , Jenne Craig , La Parker , Talai Aron Sahand , Rajashekar Deepthi , Mouches Pauline , Forkert Nils D. , Emery Carolyn , Debert Chantel T.
Published: August 2020

Objectives:

This study aimed to explore cytokine alterations following pediatric sports-related concussion (SRC) and whether a specific cytokine profile could predict symptom burden and time to return to sports (RTS).

Setting:

Sports Medicine Clinic.

Participants:

Youth ice hockey participants (aged 12-17 years) were recruited prior to the 2013-2016 hockey season.

Design:

Prospective exploratory cohort study.

Main Measure:

Following SRC, saliva samples were collected and a Sport Concussion Assessment Tool version 3 (SCAT3) was administered within 72 hours of injury and analyzed for cytokines. Additive regression of decision stumps was used to model symptom burden and length to RTS based on cytokine and clinical features. RRelieFF feature selection was used to determine the predictive value of each cytokine and clinical feature, as well as to identify the optimal cytokine profile for the symptom burden and RTS.

Results:

Thirty-six participants provided samples post-SRC (81% male; age 14.4 ± 1.3 years). Of these, 10 features, sex, number of previous concussions, and 8 cytokines, were identified to lead to the best prediction of symptom severity (r= 0.505,P= .002), while 12 cytokines, age, and history of previous concussions predicted the number of symptoms best (r= 0.637,P< .001). The prediction of RTS led to the worst results, requiring 21 cytokines, age, sex, and number of previous concussions as features (r= −0.320,P= .076).

Conclusions:

In pediatric ice hockey participants following SRC, there is evidence of saliva cytokine profiles that are associated with increased symptom burden. However, further studies are needed.
Histone deacetylase 3 in hippocampus contributes to memory impairment after chronic constriction injury of sciatic nerve in mice
Authors: Zhang Guang-Fen , Zhou Zhi-Qiang , Guo Jie , Gu Han-Wen , Su Ming-Zhao , Yu Bao-Cong , Zhou Feng , Han Bao-Yu , Jia Min , Ji Mu-Huo , Tao Yuan-Xiang , Zhao Chun-Jie , Yang Jian-Jun
Published: August 2020

Chronic neuropathic pain is frequently accompanied by memory impairment, yet the underlying mechanisms remain unclear. Here, we showed that mice displayed memory impairment starting at 14 days and lasting for at least 21 days after chronic constriction injury (CCI) of unilateral sciatic nerve in mice. Systemic administration of the pan histone deacetylase (HDAC) inhibitor sodium butyrate attenuated this memory impairment. More specifically, we found that hippocampus HDAC3 was involved in this process because the levels of its mRNA and protein increased significantly in the hippocampus at 14 and 21 days after CCI, but not sham surgery. Systemic administration of the selective HDAC3 antagonist RGFP966 attenuated CCI-induced memory impairment, improved hippocampal long-term potentiation impairment, and rescued reductions of dendritic spine density and synaptic plasticity-associated protein in the hippocampus. In addition, HDAC3 overexpression in the hippocampus led to memory impairment without affecting basal nociceptive responses in naive mice. Our findings suggest that HDAC3 contributes to memory impairment after CCI by impairing synaptic plasticity in hippocampus. Histone deacetylase 3 might serve as a potential molecular target for therapeutic treatment of memory impairment under neuropathic pain conditions.
Relationship of prosthesis ownership and phantom limb pain: results of a survey in 2383 limb amputees
Authors: Bekrater-Bodmann Robin , Reinhard Iris , Diers Martin , Fuchs Xaver , Flor Herta
Published: August 2020

Phantom limb pain (PLP) accounts for a significant reduction in quality of life and is difficult to treat. Prosthesis use has been shown to negatively covary with PLP. Recent research on body perception in amputees suggest that prosthesis ownership, defined as the extent to which a prosthesis is experienced as being part of the body rather than an artificial device foreign to the body, might interact with PLP. We used survey data from 2383 unilateral prosthesis-using upper-limb or lower-limb amputees and performed regression analyses to determine the relationship between prosthesis ownership and PLP. To test for specificity, we examined the role of prosthesis ownership also for residual limb pain (RLP) and nonpainful phantom limb sensations (npPLS). Prosthesis ownership was reduced in older participants and higher in lower-limb compared to upper-limb amputees. A longer residual limb and more frequent prosthesis use as well as a longer time since amputation also yielded higher values. Prostheses based on natural principles were associated with higher prosthesis ownership. Phantom limb pain and RLP were lower with higher prosthesis ownership, and RLP but not PLP was lower when prosthesis use was frequent. There were no significant associations for npPLS. The regression results differ in some aspects from those revealed by univariate analyses, emphasizing the importance of multivariate statistical approaches. Our findings provide insights into the interplay of body- and pain-related sensations after amputation, and could help to develop new treatment approaches for both PLP and RLP.
Role of the Infusion Nurse
Authors: Crist Janice D. , Steinheiser Marlene M.
Published: August 2020

Approximately 43 500 000 family caregivers provide unpaid care to an adult or child. Most caregivers provide care to older adults, most often parents. Caregivers are often ill-prepared to assist their loved ones, creating or increasing caregiving burden and/or risk of compassion fatigue, potentially leading to critical “caregiving tipping points.” Identifying families who are experiencing increased burden or risk of compassion fatigue is a skill that nurses, including infusion nurses, who have unique entrée into the caregiving situation, should develop. The purpose of this article is to describe “impending” tipping points before they occur and to offer solutions for how nurses can help caregiving families identify them and access additional supportive services.
Cardiac Tamponade Diagnosed by Point-of-Care Ultrasound
Authors: Smith Austin T. , Watnick Caroline , Ferre Robinson M.
Published: August 2020

We present a case involving a 12-year-old boy who presented to the emergency department and was diagnosed with a pericardial effusion with tamponade physiology by point-of-care ultrasound. The diagnosis resulted in prompt treatment and definitive therapy.
Seatbelt Syndrome in Children
Authors: Szadkowski Matthew Arthur , Bolte Robert G.
Published: August 2020

The seatbelt syndrome describes an injury pattern infrequently seen in restrained passengers in motor vehicle collisions. It occurs when sudden deceleration forces coupled with compression of the lap belt around the abdomen causes abdominal wall bruising, intra-abdominal injuries, and spinal fractures. Infrequent and improper use of appropriate belt restraints in children has led to high risks for injury in this population.

We describe a case of the seatbelt syndrome with the uncommon finding of an associated posttraumatic intestinal obstruction. We also review the literature on the prevalence, risk factors, and types of injuries sustained by children with the seatbelt syndrome as well as discuss the indications for laboratory studies, abdominal imaging, surgical intervention, and further observation. Current recommendations for child seatbelt use and its effectiveness in preventing injury are also reviewed.
Acute Illness Protocol for Organic Acidemias
Authors: Aldubayan Saud H. , Rodan Lance H. , Berry Gerard T. , Levy Harvey L.
Published: August 2020

Inborn errors of metabolism (IEM) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare, but collectively have an incidence of 1:1000. Most patients with IEMs are followed by a physician with expertise in Biochemical Genetics (Metabolism), but may present outside of this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency medicine physicians, pediatricians, internists, and critical care physicians as well as biochemical geneticists to be familiar with the initial assessment and management of patients with these disorders. Appropriate early care can be lifesaving. This protocol is not designed to replace the expert consultation of a biochemical geneticist but rather to improve early care and increase the level of comfort of the acute care physician with initial management of organic acidemias until specialty consultation is obtained.
The effectiveness of very slow switching to aripiprazole in schizophrenia patients with dopamine supersensitivity psychosis: a case series from an open study
Authors: Kanahara Nobuhisa , Takase Masayuki , Sasaki Tsuyoshi , Honma Masanori , Fujita Yasutaka , Tadokoro Shigenori , Suzuki Hitoshi , Yamanaka Hiroshi , Noda Shingo , Yanahashi Satoshi , Saiga Takahisa , Komatsu Naoya , Simoyama Takeshi , Iyo Masaomi
Published: August 2020

Dopamine supersensitivity psychosis (DSP) in patients with schizophrenia is induced by treatment with a high dosage of antipsychotics for a long time period, and it is characterized by unstable psychotic symptoms. The upregulation of dopamine D2 receptor (DRD2) provoked by antipsychotics underlies DSP. Aripiprazole does not cause an excessive blockade of DRD2 and is less likely to upregulate DRD2 by aripiprazole’s dopamine partial agonistic profile. Aripiprazole; however, has a potential risk of inducing severe rebound psychosis in patients who have already developed dopamine supersensitivity. Recently, an animal model study suggested that aripiprazole could attenuate established dopamine supersensitivity. The present study was conducted to examine whether very slowly switching to aripiprazole could help patients with schizophrenia with dopamine supersensitivity while avoiding rebound psychosis. This study was a single-armed and open-labeled study in which patients were observed over a period of 2 years. Only 11 patients were ultimately recruited. Five patients were successfully switched to a sufficient dose of aripiprazole and completed the study protocol. These five patients did not present with severe DSP over the study period, but only one patient showed a large improvement in psychopathology. Five patients dropped out of the study, and one of these five showed a severe worsening of psychosis. The present study indicated that the introduction of aripiprazole in patients with DSP was difficult, but suggested that aripiprazole could contribute to attaining a stable state in psychosis if it was applied with careful observation.
Shells of the bivalveAstarte moerchigive new evidence of a strong pelagic-benthic coupling shift occurring since the late 1970s in the North Water polynya
Authors: Olivier Frédéric , Gaillard Blandine , Thébault Julien , Meziane Tarik , Tremblay Réjean , Dumont Dany , Bélanger Simon , Gosselin Michel , Jolivet Aurélie , Chauvaud Laurent , Martel André L. , Rysgaard Søren , Olivier Anne-Hélène , Pettré Julien , Mars Jérôme , Gerber Silvain , Archambault Philippe
Published: August 2020

Climate changes in the Arctic may weaken the currently tight pelagic-benthic coupling. In response to decreasing sea ice cover, arctic marine systems are expected to shift from a ‘sea-ice algae–benthos' to a ‘phytoplankton-zooplankton’ dominance. We used mollusc shells as bioarchives and fatty acid trophic markers to estimate the effects of the reduction of sea ice cover on the food exported to the seafloor. Bathyal bivalveAstarte moerchiliving at 600 m depth in northern Baffin Bay reveals a clear shift in growth variations and Ba/Ca ratios since the late 1970s, which we relate to a change in food availability. Tissue fatty acid compositions show that this species feeds mainly on microalgae exported from the euphotic zone to the seabed. We, therefore, suggest that changes in pelagic-benthic coupling are likely due either to local changes in sea ice dynamics, mediated through bottom-up regulation exerted by sea ice on phytoplankton production, or to a mismatch between phytoplankton bloom and zooplankton grazing due to phenological change. Both possibilities allow a more regular and increased transfer of food to the seabed.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning'.
Bio-optical evidence for increasing
Phaeocystis
dominance in the Barents Sea
Authors: Orkney A. , Platt T. , Narayanaswamy B. E. , Kostakis I. , Bouman H. A.
Published: August 2020

Increasing contributions of prymnesiophytes such as
Phaeocystis pouchetii
and
Emiliania huxleyi
to Barents Sea (BS) phytoplankton production have been suggested based on
in situ
observations of phytoplankton community composition, but the scattered and discontinuous nature of these records confounds simple inference of community change or its relationship to salient environmental variables. However, provided that meaningful assessments of phytoplankton community composition can be inferred based on their optical characteristics, ocean-colour records offer a potential means to develop a synthesis between sporadic
in situ
observations. Existing remote-sensing algorithms to retrieve phytoplankton functional types based on chlorophyll-a (
chl-a
) concentration or indices of pigment packaging may, however, fail to distinguish
Phaeocystis
from other blooms of phytoplankton with high pigment packaging, such as diatoms. We develop a novel algorithm to distinguish major phytoplankton functional types in the BS and apply it to the MODIS-Aqua ocean-colour record, to study changes in the composition of BS phytoplankton blooms in July, between 2002 and 2018, creating time series of the spatial distribution and intensity of coccolithophore, diatom and
Phaeocystis
blooms. We confirm a north-eastward expansion in coccolithophore bloom distribution, identified in previous studies, and suggest an inferred increase in
chl-a
concentrations, reported by previous researchers, may be partly explained by increasing frequencies of
Phaeocystis
blooms.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning’.
Nitrate supply and uptake in the Atlantic Arctic sea ice zone: seasonal cycle, mechanisms and drivers
Authors: Henley Sian F. , Porter Marie , Hobbs Laura , Braun Judith , Guillaume-Castel Robin , Venables Emily J. , Dumont Estelle , Cottier Finlo
Published: August 2020

Nutrient supply to the surface ocean is a key factor regulating primary production in the Arctic Ocean under current conditions and with ongoing warming and sea ice losses. Here we present seasonal nitrate concentration and hydrographic data from two oceanographic moorings on the northern Barents shelf between autumn 2017 and summer 2018. The eastern mooring was sea ice-covered to varying degrees during autumn, winter and spring, and was characterized by more Arctic-like oceanographic conditions, while the western mooring was ice-free year-round and showed a greater influence of Atlantic water masses. The seasonal cycle in nitrate dynamics was similar under ice-influenced and ice-free conditions, with biological nitrate uptake beginning near-synchronously in early May, but important differences between the moorings were observed. Nitrate supply to the surface ocean preceding and during the period of rapid drawdown was greater at the ice-free more Atlantic-like western mooring, and nitrate drawdown occurred more slowly over a longer period of time. This suggests that with ongoing sea ice losses and Atlantification, the expected shift from more Arctic-like ice-influenced conditions to more Atlantic-like ice-free conditions is likely to increase nutrient availability and the duration of seasonal drawdown in this Arctic shelf region. The extent to which this increased nutrient availability and longer drawdown periods will lead to increases in total nitrate uptake, and support the projected increases in primary production, will depend on changes in upper ocean stratification and their effect on light availability to phytoplankton as changes in climate and the physical environment proceed.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning'.
Climate-driven benthic invertebrate activity and biogeochemical functioning across the Barents Sea polar front
Authors: Solan Martin , Ward Ellie R. , Wood Christina L. , Reed Adam J. , Grange Laura J. , Godbold Jasmin A.
Published: August 2020

Arctic marine ecosystems are undergoing rapid correction in response to multiple expressions of climate change, but the consequences of altered biodiversity for the sequestration, transformation and storage of nutrients are poorly constrained. Here, we determine the bioturbation activity of sediment-dwelling invertebrate communities over two consecutive summers that contrasted in sea-ice extent along a transect intersecting the polar front. We find a clear separation in community composition at the polar front that marks a transition in the type and amount of bioturbation activity, and associated nutrient concentrations, sufficient to distinguish a southern high from a northern low. While patterns in community structure reflect proximity to arctic versus boreal conditions, our observations strongly suggest that faunal activity is moderated by seasonal variations in sea ice extent that influence food supply to the benthos. Our observations help visualize how a climate-driven reorganization of the Barents Sea benthic ecosystem may be expressed, and emphasize the rapidity with which an entire region could experience a functional transformation. As strong benthic-pelagic coupling is typical across most parts of the Arctic shelf, the response of these ecosystems to a changing climate will have important ramifications for ecosystem functioning and the trophic structure of the entire food web.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning'.
Annual cycle of downward particle fluxes on each side of the Gakkel Ridge in the central Arctic Ocean
Authors: Nöthig Eva-Maria , Lalande Catherine , Fahl Kirsten , Metfies Katja , Salter Ian , Bauerfeind Eduard
Published: August 2020

Two mooring arrays carrying sediment traps were deployed from September 2011 to August 2012 at ∼83°N on each side of the Gakkel Ridge in the Nansen and Amundsen Basins to measure downward particle flux below the euphotic zone (approx. 250 m) and approximately 150 m above seafloor at approximately 3500 and 4000 m depth, respectively. In a region that still experiences nearly complete ice cover throughout the year, export fluxes of total particulate matter (TPM), particulate organic carbon (POC), particulate nitrogen (PN), biogenic matter, lithogenic matter, biogenic particulate silica (bPSi), calcium carbonate (CaCO
3
), protists and biomarkers only slightly decreased with depth. Seasonal variations of particulate matter fluxes were similar on both sides of the Gakkel Ridge. Somewhat higher export rates in the Amundsen Basin and differences in the composition of the sinking TPM and bPSi on each side of the Gakkel Ridge probably reflected the influence of the Lena River/Transpolar Drift in the Amundsen Basin and the influence of Atlantic water in the Nansen Basin. Low variations in particle export with depth revealed a limited influence of lateral advection in the deep barren Eurasian Basin.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning’.
Climate change and diminishing seasonality in Arctic benthic processes
Authors: Morata Nathalie , Michaud Emma , Poullaouec Marie-Aude , Devesa Jérémy , Le Goff Manon , Corvaisier Rudolph , Renaud Paul E.
Published: August 2020

The iconic picture of Arctic marine ecosystems shows an intense pulse of biological productivity around the spring bloom that is sustained while fresh organic matter (OM) is available, after which ecosystem activity declines to basal levels in autumn and winter. We investigated seasonality in benthic biogeochemical cycling at three stations in a high Arctic fjord that has recently lost much of its seasonal ice-cover. Unlike observations from other Arctic locations, we find little seasonality in sediment community respiration and bioturbation rates, although different sediment reworking modes varied through the year. Nutrient fluxes did vary, suggesting that, although OM was processed at similar rates, seasonality in its quality led to spring/summer peaks in inorganic nitrogen and silicate fluxes. These patterns correspond to published information on seasonality in vertical flux at the stations. Largely ice-free Kongsfjorden has a considerable detrital pool in soft sediments which sustain benthic communities over the year. Sources of this include macroalgae and terrestrial runoff. Climate change leading to less ice cover, higher light availability and expanded benthic habitat may lead to more detrital carbon in the system, dampening the quantitative importance of seasonal pulses of phytodetritus to seafloor communities in some areas of the Arctic.

This article is part of the theme issue ‘The changing Arctic Ocean: consequences for biological communities, biogeochemical processes and ecosystem functioning'.
Diagnosis of COVID-19 from X-rays Using Combined CNN-RNN Architecture with Transfer Learning
Authors: Al-Rakhami Mabrook S. , Islam Md. Milon , Islam Md. Zabirul , Asraf Amanullah , Sodhro Ali Hassan , Ding Weiping
Published: August 2020

The confrontation of COVID-19 pandemic has become one of the promising challenges of the world healthcare. Accurate and fast diagnosis of COVID-19 cases is essential for correct medical treatment to control this pandemic. Compared with the reverse-transcription polymerase chain reaction (RT-PCR) method, chest radiography imaging techniques are shown to be more effective to detect coronavirus. For the limitation of available medical images, transfer learning is better suited to classify patterns in medical images. This paper presents a combined architecture of convolutional neural network (CNN) and recurrent neural network (RNN) to diagnose COVID-19 from chest X-rays. The deep transfer techniques used in this experiment are VGG19, DenseNet121, InceptionV3, and Inception-ResNetV2. CNN is used to extract complex features from samples and classified them using RNN. The VGG19-RNN architecture achieved the best performance among all the networks in terms of accuracy in our experiments. Finally, Gradient-weighted Class Activation Mapping (Grad-CAM) was used to visualize class-specific regions of images that are responsible to make decision. The system achieved promising results compared to other existing systems and might be validated in the future when more samples would be available. The experiment demonstrated a good alternative method to diagnose COVID-19 for medical staff.
Phosphate levels and pulmonary damage in COVID-19 patients based on CO-RADS scheme: is there any link between parathyroid gland and COVID-19?
Authors: Javdani Farshid , Parsa Shima , Shakeri Heshmatollah , Hatami Naser , Kalani Navid , Haghbeen Marzieh , Raufi Rahim , Abbasi Alireza , Keshavarz Pouyan , Hashemi Seyyed Abbas , shafiee Amin
Published: August 2020

Background

Preliminary studies of COVID-19 have provided some evidence that electrolyte disturbances may also be present in patients. In this study we aimed to evaluate the role of the arrival electrolytes and symptoms in prediction of Lung damage in CT scan based on the CO-RADS system.

Methods

This was a retrospective cross-sectional analytical study. We included patients with laboratory confirmed COVID-19 infection, June 15 to July 7. Patients were included in study if there were no previous history of kidney disease. Demographic, clinical characteristics, laboratory findings, and CO-RADS High-resolution computed tomography (HRCT) of lung report were collected. Univariate logistic regression was employed first to identify the effective, correlated items. All statistics were performed with SPSS version 18.0.

Results

In the current study, 36 (20 male- 16 female) patients with mean age of the 54.7±17.5 years old were studied. Most common symptom at the arrival was the Fever (52.8%), followed by Fatigue (18%), and dyspnea (44.4%). Computed tomography assessment revealed CO-RADS 2 in 4 (11.1%) patients, CORADS 3 in 1 (2.8%), CO-RADS 4 in 20 (55.6%), and CO-RADS 5 in 11 (30.6%) patients. In the comparison with the study groups based on the HRCT status (CO-RADS II,III vs. CO-RADS IV,V), patients with severe HRCT damage had significantly lower level of Phosphorus (P < 0.01). Univariate logistic regression analysis showed that only one factors was associated with HRCT damage status (Phosphorus, P=0.040). Phosphorus upper than 4.5 was associated with better HRCT results with OR ratio of 3.71 (X2(1)=5.69; p=0.017).

Conclusion

Our study illustrates that higher phosphate levels may be associated with better CT scan of lung outcomes in COVID-19; while hypophosphatemia is associated with severe lung injuries. This could help clinicians to manage hospitalized patients and may link the COVID-19 and parathyroid gland.
Smoking Impairs Women’s Verbal Learning and Memory Performance More than Men’s: An International Web-Cohort Study of 70,000 Participants
Authors: Lewis C.R. , Talboom J.S. , Both M.D. De , Schmidt A.M. , Naymik M.A. , Håberg A.K. , Rundek T. , Levin B.E. , Hoscheidt S. , Bolla Y. , Brinton R.D. , Hay M. , Barnes C.A. , Glisky E. , Ryan L. , Huentelman M.J.
Published: August 2020

ABRSTACT

Background

Vascular contributions to cognitive impairment and dementia (VCID) include structural and functional blood vessel injuries linked to poor neurocognitive outcomes. Smoking might indirectly increase the likelihood of cognitive impairment by exacerbating the risks associated with underlying vascular disease. Sex disparities in VCID have been reported, however, few studies have assessed the sex-specific impact of smoking on cognitive function and with contradictory results. This is an important topic since smoking and cardiovascular disease negatively impact health and possibly women have the greater lifetime risk of stroke and dementia than men. In this study, we sought to investigate the effect-modification of sex on the relationship between smoking, cardiovascular disease and verbal learning and memory function.

Methods

Using MindCrowd, a web-based cohort of over 70,000 people aged 18 - 85, we investigated whether sex modifies the impact of smoking and cardiovascular disease on verbal memory performance on a paired-associate learning task using both multiple regression and propensity matching approaches. Artificial error introduction and permutation testing underscored the stability of our results. To demonstrate the necessity of large sample sizes to detect an interaction of sex and smoking, we performed down sampling analyses.

Findings

We found significant interactions in that smoking impacts verbal learning performance more in women and cardiovascular disease more in men across a wide age range.

Interpretation

These results suggest that smoking and cardiovascular disease impact verbal learning and memory throughout adulthood. Smoking particularly affects learning and memory in women and cardiovascular disease has a larger effect in men. Although the reasons for these sex-modification effects are not entirely understood, our findings highlight the importance of considering biological sex in VCID.

Funding

Mueller Family Charitable Trust; Arizona Alzheimer’s Consortium; Flinn Foundation; The McKnight Brain Research Foundation; NIH-NIA grant R01-AG049465.
Dynamic deformable attention (DDANet) for semantic segmentation
Authors: Rajamani Kumar T. , Siebert Hanna , Heinrich Mattias P.
Published: August 2020

Deep learning based medical image segmentation is an important step within diagnosis, which relies strongly on capturing sufficient spatial context without requiring too complex models that are hard to train with limited labelled data. Training data is in particular scarce for segmenting infection regions of CT images of COVID-19 patients. Attention models help gather contextual information within deep networks and benefit semantic segmentation tasks. The recent criss-cross-attention module aims to approximate global self-attention while remaining memory and time efficient by separating horizontal and vertical selfsimilarity computations. However, capturing attention from all non-local locations can adversely impact the accuracy of semantic segmentation networks. We propose a new Dynamic Deformable Attention Network (DDANet) that enables a more accurate contextual information computation in a similarly efficient way. Our novel technique is based on a deformable criss-cross attention block that learns both attention coefficients and attention offsets in a continuous way. A deep segmentation network (in our case a U-Net [1]) that employs this attention mechanism is able to capture attention from pertinent non-local locations and also improves the performance on semantic segmentation tasks compared to criss-cross attention within a U-Net on a challenging COVID-19 lesion segmentation task. Our validation experiments show that the performance gain of the recursively applied dynamic deformable attention blocks comes from their ability to capture dynamic and precise (wider) attention context. Our DDANet achieves Dice scores of 73.4% and 61.3% for Ground-Glass-Opacity and Consolidation lesions for COVID-19 segmentation and improves the accuracy by 4.9% points compared to a baseline U-Net.
ICU Outcomes and Survival in Patients with Severe COVID-19 in the Largest Health Care System in Central Florida
Authors: Oliveira Eduardo , Parikh Amay , Lopez-Ruiz Arnaldo , Carrilo Maria , Goldberg Joshua , Cearras Martin , Fernainy Khaled , Andersen Sonja , Mercado Luis , Guan Jian , Zafar Hammad , Louzon Patricia , Carr Amy , Baloch Natasha , Pratley Richard , Silverstry Scott , Hsu Vincent , Sniffen Jason , Herrera Victor , Finkler Neil
Published: August 2020

Background

Observational studies have consistently described poor clinical outcomes and increased ICU mortality in patients with severe coronavirus disease 2019 (COVID-19) who require mechanical ventilation (MV). Our study describes the clinical characteristics and outcomes of patients with severe COVID-19 admitted to ICU in the largest health care system in the state of Florida, United States.

Methods

Retrospective cohort study of patients admitted to ICU due to severe COVID-19 in AdventHealth health system in Orlando, Florida from March 11th until May 18th, 2020. Patients were characterized based on demographics, baseline comorbidities, severity of illness, medical management including experimental therapies, laboratory markers and ventilator parameters. Major clinical outcomes analyzed at the end of the study period were: hospital and ICU length of stay, MV-related mortality and overall hospital mortality of ICU patients.

Results

Out of total of 1283 patients with COVID-19, 131 (10.2%) met criteria for ICU admission (median age: 61 years [interquartile range {IQR}, 49.5-71.5]; 35.1% female). Common comorbidities were hypertension (84; 64.1%), and diabetes (54; 41.2%). Of the 131 ICU patients, 109 (83.2%) required MV and 9 (6.9%) received ECMO. Lower positive end expiratory pressure (PEEP) were observed in survivors [9.2 (7.7-10.4)] vs non-survivors [10 (9.1-12.9] p= 0.004]. Compared to non-survivors, survivors had a longer MV length of stay (LOS) [14 (IQR 8-22) vs 8.5 (IQR 5-10.8) p< 0.001], Hospital LOS [21 (IQR 13-31) vs 10 (7-1) p< 0.001] and ICU LOS [14 (IQR 7-24) vs 9.5 (IQR 6-11), p < 0.001]. The overall hospital mortality and MV-related mortality were 19.8% and 23.8% respectively. After exclusion of hospitalized patients, the hospital and MV-related mortality rates were 21.6% and 26.5% respectively.

Conclusions

Our study demonstrates an important improvement in mortality of patients with severe COVID-19 who required ICU admission and MV in comparison to previous observational reports and emphasize the importance of standard of care measures in the management of COVID-19.
Cost-effectiveness of sleeping sickness elimination campaigns in five settings of the Democratic Republic of Congo
Authors: Antillon Marina , Huang Ching-I , Crump Ronald E. , Brown Paul E. , Snijders Rian , Miaka Erick Mwamba , Keeling Matt J. , Rock Kat S. , Tediosi Fabrizio
Published: August 2020

Gambiense human African trypanosomiasis (gHAT) is marked for elimination of transmission (EOT) by 2030, but the disease persists in several low-income countries. We coupled transmission and health outcomes models to examine the cost-effectiveness of four gHAT elimination strategies in in five settings – spanning low- to high-risk – of the Democratic Republic of Congo. Alongside passive screening (PS) in fixed health facilities, the strategies included active screening (AS) at average or intensified coverage levels, alone or with vector control (VC) with a scale-back algorithm when no cases were reported for three consecutive years. In high or moderate-risk settings, costs of gHAT strategies are primarily driven by AS and, if used, VC. Due to the cessation of AS and VC, most investments (75-80%) will be made by 2030 and VC might be cost-saving while ensuring EOT. In low-risk settings, costs are driven by PS, and minimum-cost strategies consisting of AS and PS lead to EOT by 2030 with high probability.