bluuebunny/crossref_metadata_2025 huggingface dataset:
Nudging healthcare professionals in clinical settings: a scoping review of the literature
Authors: Sant’Anna Anita , Vilhelmsson Andreas , Wolf Axel
Published: June 2021

Background

Healthcare organisations are in constant need of improvement and change. Nudging has been proposed as a strategy to affect people’s choices and has been used to affect patients’ behaviour in healthcare settings. However, little is known about how nudging is being interpreted and applied to change the behaviour of healthcare professionals (HCPs). The objective of this review is to identify interventions using nudge theory to affect the behaviour of HCPs in clinical settings.

Methods

A scoping review. We searched PubMed and PsycINFO for articles published from 2010 to September 2019, including terms related to “nudging” in the title or abstract. Two reviewers screened articles for inclusion based on whether the articles described an intervention to change the behaviour of HCPs. Two reviewers extracted key information and categorized included articles. Descriptive analyses were performed on the data.

Results

Search results yielded 997 unique articles, of which 25 articles satisfied the inclusion criteria. Five additional articles were selected from the reference lists of the included articles. We identified 11 nudging strategies: accountable justification, goal setting, suggested alternatives, feedback, information transparency, peer comparison, active choice, alerts and reminders, environmental cueing/priming, defaults/pre-orders, and education. These strategies were employed to affect the following 4 target behaviours: vaccination of staff, hand hygiene, clinical procedures, prescriptions and orders. To compare approaches across so many areas, we introduced two independent dimensions to describe nudging strategies: synchronous/asynchronous, and active/passive.

Conclusion

There are relatively few studies published referring to nudge theory aimed at changing HCP behaviour in clinical settings. These studies reflect a diverse set of objectives and implement nudging strategies in a variety of ways. We suggest distinguishing active from passive nudging strategies. Passive nudging strategies may achieve the desired outcome but go unnoticed by the clinician thereby not really changing a behaviour and raising ethical concerns. Our review indicates that there are successful active strategies that engage with clinicians in a more deliberate way. However, more research is needed on how different nudging strategies impact HCP behaviour in the short and long term to improve clinical decision making.
The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials
Authors: Louise Jennie , Poprzeczny Amanda J. , Deussen Andrea R. , Vinter Christina , Tanvig Mette , Jensen Dorte Moller , Bogaerts Annick , Devlieger Roland , McAuliffe Fionnuala M. , Renault Kristina M. , Carlsen Emma , Geiker Nina , Poston Lucilla , Briley Annette , Thangaratinam Shakila , Dodd Jodie M.
Published: June 2021

Background

The impact of maternal obesity extends beyond birth, being independently associated with an increased risk of child obesity. Current evidence demonstrates that women provided with a dietary intervention during pregnancy improve their dietary quality and have a modest reduction in gestational weight gain. However, the effect of this on longer-term childhood obesity-related outcomes is unknown.

Methods

We conducted an individual participant data meta-analysis from RCTs in which women with a singleton, live gestation between 10+0 and 20+0 weeks and body mass index (BMI) ≥ 25 kg/m2 in early pregnancy were randomised to a diet and/or lifestyle intervention or continued standard antenatal care and in which longer-term maternal and child follow-up at 3–5 years of age had been undertaken. The primary childhood outcome was BMI z-score above the 90th percentile. Secondary childhood outcomes included skinfold thickness measurements and body circumferences, fat-free mass, dietary and physical activity patterns, blood pressure, and neurodevelopment.

Results

Seven primary trials where follow-up of participants occurred were identified by a systematic literature search within the International Weight Management in Pregnancy (i-WIP) Collaborative Group collaboration, with six providing individual participant data. No additional studies were identified after a systematic literature search. A total of 2529 children and 2383 women contributed data. Approximately 30% of all child participants had a BMI z-score above the 90th percentile, with no significant difference between the intervention and control groups (aRR 0.97; 95% CI 0.87, 1.08; p=0.610). There were no statistically significant differences identified for any of the secondary outcome measures.

Conclusions

In overweight and obese pregnant women, we found no evidence that maternal dietary and/or lifestyle intervention during pregnancy modifies the risk of early childhood obesity. Future research may need to target the pre-conception period in women and early childhood interventions.

Trial registration

PROSPERO, CRD42016047165
The roles of tumor-derived exosomes in altered differentiation, maturation and function of dendritic cells
Authors: Hosseini Reza , Asef-Kabiri Leila , Yousefi Hassan , Sarvnaz Hamzeh , Salehi Majid , Akbari Mohammad Esmaeil , Eskandari Nahid
Published: June 2021

Tumor-derived exosomes (TDEs) have been shown to impede anti-tumor immune responses via their immunosuppressive cargo. Since dendritic cells (DCs) are the key mediators of priming and maintenance of T cell-mediated responses; thus it is logical that the exosomes released by tumor cells can exert a dominant influence on DCs biology. This paper intends to provide a mechanistic insight into the TDEs-mediated DCs abnormalities in the tumor context. More importantly, we discuss extensively how tumor exosomes induce subversion of DCs differentiation, maturation and function in separate sections. We also briefly describe the importance of TDEs at therapeutic level to help guide future treatment options, in particular DC-based vaccination strategy, and review advances in the design and discovery of exosome inhibitors. Understanding the exosomal content and the pathways by which TDEs are responsible for immune evasion may help to revise treatment rationales and devise novel therapeutic approaches to overcome the hurdles in cancer treatment.
Brain pharmacokinetics of two BBB penetrating bispecific antibodies of different size
Authors: Faresjö Rebecca , Bonvicini Gillian , Fang Xiaotian T. , Aguilar Ximena , Sehlin Dag , Syvänen Stina
Published: June 2021

Background

Transferrin receptor (TfR1) mediated enhanced brain delivery of antibodies have been studied extensively in preclinical settings. However, the brain pharmacokinetics, i.e. brain entry, distribution and elimination are still not fully understood for this class of antibodies. The overall aim of the study was to compare the brain pharmacokinetics of two BBB-penetrating bispecific antibodies of different size (210 vs 58 kDa). Specifically, we wanted to investigate if the faster systemic clearance of the smaller non-IgG antibody di-scFv3D6-8D3, in comparison with the IgG-based bispecific antibody mAb3D6-scFv8D3, was also reflected in the brain.

Methods

Wild-type (C57/Bl6) mice were injected with125I-iodinated ([125I]) mAb3D6-scFv8D3 (n = 46) or [125I]di-scFv3D6-8D3 (n = 32) and euthanized 2, 4, 6, 8, 10, 12, 16, or 24 h post injection. Ex vivo radioactivity in whole blood, peripheral organs and brain was measured by γ-counting. Ex vivo autoradiography and nuclear track emulsion were performed on brain sections to investigate brain and parenchymal distribution. Capillary depletion was carried out at 2, 6, and 24 h after injection of [125I]mAb3D6-scFv8D3 (n = 12) or [125I]di-scFv3D6-8D3 (n = 12), to estimate the relative levels of radiolabelled antibody in brain capillaries versus brain parenchyma. In vitro binding kinetics for [125I]mAb3D6-scFv8D3 or [125I]di-scFv3D6-8D3 to murine TfR were determined by LigandTracer.

Results

[125I]di-scFv3D6-8D3 showed faster elimination from blood, lower brain Cmax, and Tmax, a larger parenchymal-to-capillary concentration ratio, and a net elimination from brain at an earlier time point after injection compared with the larger [125I]mAb3D6-scFv8D3. However, the elimination rate from brain did not differ between the antibodies. The study also indicated that [125I]di-scFv3D6-8D3 displayed lower avidity than [125I]mAb3D6-scFv8D3 towards TfR1 in vitro and potentially in vivo, at least at the BBB.

Conclusion

A smaller size and lower TfR1 avidity are likely important for fast parenchymal delivery, while elimination of brain-associated bispecific antibodies may not be dependent on these characteristics.
Direct and indirect costs and cost-driving factors in adults with tuberous sclerosis complex: a multicenter cohort study and a review of the literature
Authors: Zöllner Johann Philipp , Grau Janina , Rosenow Felix , Sauter Matthias , Knuf Markus , Kurlemann Gerhard , Mayer Thomas , Hertzberg Christoph , Bertsche Astrid , Immisch Ilka , Klein Karl Martin , Knake Susanne , Marquard Klaus , Meyer Sascha , Noda Anna H. , von Podewils Felix , Schäfer Hannah , Thiels Charlotte , Willems Laurent M. , Zukunft Bianca , Schubert-Bast Susanne , Strzelczyk Adam
Published: June 2021

Background

Tuberous sclerosis complex (TSC) is a monogenetic, multisystem disorder characterized by benign growths due to TSC1 or TSC2 mutations. This German multicenter study estimated the costs and related cost drivers associated with organ manifestations in adults with TSC.

Methods

A validated, three-month, retrospective questionnaire assessed the sociodemographic and clinical characteristics, organ manifestations, direct, indirect, out-of-pocket (OOP), and nursing care-level costs among adult individuals with TSC throughout Germany from a societal perspective (costing year: 2019).

Results

We enrolled 192 adults with TSC (mean age: 33.4 ± 12.7 years; range: 18–78 years, 51.6% [n = 99] women). Reported TSC disease manifestations included skin (94.8%) and kidney and urinary tract (74%) disorders, epilepsy (72.9%), structural brain defects (67.2%), psychiatric disorders (50.5%), heart and circulatory system disorders (50.5%), and lymphangioleiomyomatosis (11.5%). TSC1 and TSC2 mutations were reported in 16.7% and 25% of respondents, respectively. Mean direct health care costs totaled EUR 6452 (median EUR 1920; 95% confidence interval [CI] EUR 5533–7422) per patient over three months. Medication costs represented the major direct cost category (77% of total direct costs; mean EUR 4953), and mechanistic target of rapamycin (mTOR) inhibitors represented the largest share (68%, EUR 4358). Mean antiseizure drug (ASD) costs were only EUR 415 (6%). Inpatient costs (8%, EUR 518) and outpatient treatment costs (7%; EUR 467) were important further direct cost components. The mean care grade allowance as an approximator of informal nursing care costs was EUR 929 (median EUR 0; 95% CI EUR 780–1083) over three months. Mean indirect costs totaled EUR 3174 (median EUR 0; 95% CI EUR 2503–3840) among working-age individuals (< 67 years in Germany). Multiple regression analyses revealed mTOR inhibitor use and persistent seizures as independent cost-driving factors for total direct costs. Older age and disability were independent cost-driving factors for total indirect costs, whereas epilepsy, psychiatric disease, and disability were independent cost-driving factors for nursing care costs.

Conclusions

This three-month study revealed substantial direct healthcare, indirect healthcare, and medication costs associated with TSC in Germany. This study highlights the spectrum of organ manifestations and their associated treatment needs in the German healthcare setting. Trial registration: DRKS, DRKS00016045. Registered 01 March 2019, http://www.drks.de/DRKS00016045.
Diabetes outbreak during COVID19 lock-down in a prediabetic patient with cystic fibrosis long treated with glargine
Authors: Rosanio Francesco Maria , Mozzillo Enza , Cimbalo Chiara , Casertano Alberto , Sepe Angela , Raia Valeria , Franzese Adriana , Tosco Antonella
Published: June 2021

Background

Cystic Fibrosis Related Diabetes (CFRD) is a frequent comorbidity of patients with Cystic Fibrosis (CF). A worsening of clinical conditions appears before CFRD. It has been demonstrated a decline in pulmonary function and nutritional status also in patients with prediabetes. Few trials show that insulin may be beneficial in prediabetic CF patients, to date guidelines do not recommend for this condition.

Case presentation

We report a case of a patient treated with insulin glargine at 13 years, due to glycemic intolerance, and with Lumacaftor/Ivacaftor at 15 years. A reduction of pulmonary exacerbations was observed after glargine therapy, also confirmed after the starting of Lumacaftor/ Ivacaftor in this patient. Pulmonary function improved only after the first year of glargine therapy, then a deterioration appeared due to the natural history of CF lung damage. During the COVID-19 lockdown, poor adherence to care contributed to diabetes mellitus onset needing high insulin requirements. After two weeks the patient returned to prediabetic condition and his previous dose of glargine.

Conclusions

our case highlights firstly that insulin glargine has contributed to preserve him from further clinical worsening due to prediabetes in the years before pandemic, secondly the negative impact of COVID-19 lockdown on the clinical course of a chronic disease as CF.
A case report of a boy suffering from type 1 diabetes mellitus and familial Mediterranean fever
Authors: Gicchino Maria Francesca , Iafusco Dario , Zanfardino Angela , del Giudice Emanuele Miraglia , Olivieri Alma Nunzia
Published: June 2021

Background

Type 1 diabetes mellitus could be associated with other autoimmune diseases, such as autoimmune thyroid disease, celiac disease, but the association with Familial Mediterranean Fever is rare, we describe a case of a boy with type 1 Diabetes Mellitus associated with Familial Mediterranean Fever (FMF).

Case presentation

A 13 year old boy already suffering from Diabetes Mellitus type 1 since the age of 4 years, came to our attention because of periodic fever associated with abdominal pain, chest pain and arthralgia. The fever appeared every 15–30 days with peaks that reached 40 °C and lasted 24–48 h. Laboratory investigation, were normal between febrile episodes, but during the attacks revealed an increase in inflammatory markers. Suspecting Familial Mediterranean Fever molecular analysis of MEFV gene, was performed. The genetic analysis showed homozygous E148Q mutation. So Familial Mediterranean Fever was diagnosed and colchicine treatment was started with good response.

Conclusion

Familial Mediterranean Fever could be associated with other autoimmune diseases such as Ankylosing Spondylitis, Rheumatoid Arthritis, Polyarteritis Nodosa, Behcet disease, Systemic Lupus, Henoch-Schönlein Purpura, and Hashimoto’s Thyroiditis. Association of type 1 Diabetes Mellitus and Familial Mediterranean Fever has been newly reported in the medical literature, this is the third association of these two diseases described in the medical literature so far.
Endoscopic vacuum therapy versus stent treatment of esophageal anastomotic leaks (ESOLEAK): study protocol for a prospective randomized phase 2 trial
Authors: Tachezy Michael , Chon Seung-Hun , Rieck Isabel , Kantowski Marcus , Christ Hildegard , Karstens Karl , Gebauer Florian , Goeser Tobias , Rösch Thomas , Izbicki Jakob R. , Bruns Christiane J.
Published: June 2021

Background

Intrathoracic anastomotic leaks represent a major complication after Ivor Lewis esophagectomy. There are two promising endoscopic treatment strategies in the case of leaks: the placement of self-expanding metal stents (SEMS) or endoscopic vacuum therapy (EVT). Up to date, there is no prospective data concerning the optimal endoscopic treatment strategy. This is a protocol description for the ESOLEAK trial, which is a first small phase 2 randomized trial evaluating the quality of life after treatment of anastomotic leaks by either SEMS placement or EVT.

Methods

This phase 2 randomized trial will be conducted at two German tertiary medical centers and include a total of 40 patients within 2 years. Adult patients with histologically confirmed esophageal cancer, who have undergone Ivor Lewis esophagectomy and show an esophagogastric anastomotic leak on endoscopy or present with typical clinical signs linked to an anastomotic leak, will be included in our study taking into consideration the exclusion criteria. After endoscopic verification of the anastomotic leak, patients will be randomized in a 1:1 ratio into two treatment groups. The intervention group will receive EVT whereas the control group will be treated with SEMS. The primary endpoint of this study is the subjective quality of life assessed by the patient using a systematic and validated questionnaire (EORTC QLQ C30, EORTC QLQ-OES18 questionnaire). Important secondary endpoints are healing rate, period of hospitalization, treatment-related complications, and overall mortality.

Discussion

The latest meta-analysis comparing implantation of SEMS with EVT in the treatment of esophageal anastomotic leaks suggested a higher success rate for EVT. The ESOLEAK trial is the first study comparing both treatments in a prospective manner. The aim of the trial is to find suitable endpoints for the treatment of anastomotic leaks as well as to enable an adequate sample size calculation and evaluate the feasibility of future interventional trials. Due to the exploratory design of this pilot study, the sample size is too small to answer the question, whether EVT or SEMS implantation represents the superior treatment strategy.

Trial registration

ClinicalTrials.gov NCT03962244. Registered on May 23, 2019.

DRKS-ID DRKS00007941
Evaluation of sleep quality and anxiety in Italian pediatric healthcare workers during the first wave of COVID-19 pandemic
Authors: Di Filippo Paola , Attanasi Marina , Dodi Giulia , Porreca Annamaria , Raso Massimiliano , Di Pillo Sabrina , Chiarelli Francesco
Published: June 2021

Objective

The aim of this study was to evaluate sleep quality and psychological effects on pediatric healthcare workers during the first wave of COVID-19 epidemic in Italy and to evaluate differences between primary and secondary care operators. Pediatric healthcare workers were involved in an online survey to assess sleep quality, stress and anxiety level, self-efficacy and social support in Italian pediatric healthcare workers during COVID-19 pandemic.

Results

We found that 67.4% of our sample suffered from sleep disturbance and 19.4% of subjects suffered from anxiety. Lower values of anxiety and social support were found in primary care staff compared to secondary care one. The associations between healthcare professional figures (being primary or secondary care operators) and mental health outcomes were not statistically significant. However, sex, age and having a SARS-CoV-2 infected relative/friend had an independent effect on mental health outcomes. It is crucial to provide social and psychological support to pediatric healthcare workers. A tailored psychological screening would be desirable for female healthcare workers and for those who have a SARS-CoV-2 infected relative/friend.
Management of a spontaneous supra-aortic arterial dissection: a case report
Authors: Sharaf Omar M. , Martin Tomas D. , Jeng Eric I.
Published: June 2021

Background

Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae.

Case presentation

A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management—anti-impulse regimen, antiplatelet therapy, and close follow-up.

Conclusions

Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.
Holobiont nitrogen control and its potential for eutrophication resistance in an obligate photosymbiotic jellyfish
Authors: Röthig Till , Puntin Giulia , Wong Jane C. Y. , Burian Alfred , McLeod Wendy , Baker David M.
Published: June 2021

Background

Marine holobionts depend on microbial members for health and nutrient cycling. This is particularly evident in cnidarian-algae symbioses that facilitate energy and nutrient acquisition. However, this partnership is highly sensitive to environmental change—including eutrophication—that causes dysbiosis and contributes to global coral reef decline. Yet, some holobionts exhibit resistance to dysbiosis in eutrophic environments, including the obligate photosymbiotic scyphomedusa Cassiopea xamachana.

Methods

Our aim was to assess the mechanisms in C. xamachana that stabilize symbiotic relationships. We combined labelled bicarbonate (13C) and nitrate (15N) with metabarcoding approaches to evaluate nutrient cycling and microbial community composition in symbiotic and aposymbiotic medusae.

Results

C-fixation and cycling by algal Symbiodiniaceae was essential for C. xamachana as even at high heterotrophic feeding rates aposymbiotic medusae continuously lost weight. Heterotrophically acquired C and N were readily shared among host and algae. This was in sharp contrast to nitrate assimilation by Symbiodiniaceae, which appeared to be strongly restricted. Instead, the bacterial microbiome seemed to play a major role in the holobiont’s DIN assimilation as uptake rates showed a significant positive relationship with phylogenetic diversity of medusa-associated bacteria. This is corroborated by inferred functional capacity that links the dominant bacterial taxa (~90 %) to nitrogen cycling. Observed bacterial community structure differed between apo- and symbiotic C. xamachana putatively highlighting enrichment of ammonium oxidizers and nitrite reducers and depletion of nitrogen-fixers in symbiotic medusae.

Conclusion

Host, algal symbionts, and bacterial associates contribute to regulated nutrient assimilation and cycling in C. xamachana. We found that the bacterial microbiome of symbiotic medusae was seemingly structured to increase DIN removal and enforce algal N-limitation—a mechanism that would help to stabilize the host-algae relationship even under eutrophic conditions.
High precision 3-D coordinates for JSATS tagged fish in an acoustically noisy environment
Authors: Nebiolo Kevin P. , Meyer Thomas H.
Published: June 2021

Background

Acoustic tagging methods have been used to track fish for some time. Multiple systems have been developed, including those that give researchers the ability to position fish in three dimensions and time. However, proprietary positioning methods have suffered from a lack of transparency. The U.S. Department of Energy and the U.S. Army Corps of Engineers developed the Juvenile Salmon Acoustic Telemetry System (JSATS) to monitor the survivability of juvenile salmonids as they migrate downstream. With much smaller tags and high ping rates, JSATS positioning studies should be more prevalent, but implementation is difficult and often out of reach for small budget-minded studies. This study implemented a small scale JSATS positioning study using relatively inexpensive, autonomous, independent receivers. We will show that proper synchronization of the transmissions and elimination of multipath allows the positions of a smolt to be determined in three spatial dimensions over time with high precision.

Results

Tracking of 172 tagged smolts produced a total of nearly 2,00,000 positions. We compared the performance of four different supervised machine learning classifiers (Support Vector Classifier (SVC), Gaussian Naïve Bayes (NB), Classification Tree (CART), and K-Nearest Neighbor (KNN). All algorithms performed well with high accuracy and precision, but recall rates decreased with distance from the source. The SVC and KNN were least restrictive in practice. Overall, the SVC had the longest time to solve.

Conclusion

Positions determined from fish outside of the convex hull of the hydrophones were effectively being extrapolated, while positions determined from within the convex hull nearly always met or exceeded 1-m precision. Having stationary submerged hydrophones was necessary to produce three-dimensional positions. The main technical advances presented are the hydrophone-clock synchronization scheme and the multipath rejection scheme, which found the best multipath classifier to be the K-Nearest Neighbor. Neither algorithm was capable of alleviating close proximity detection interference (CPDI), suggesting the need to reposition receivers from reflective surfaces or install baffling.
How do you feel during the COVID-19 pandemic? A survey using psychological and linguistic self-report measures, and machine learning to investigate mental health, subjective experience, personality, and behaviour during the COVID-19 pandemic among university students
Authors: Herbert Cornelia , El Bolock Alia , Abdennadher Slim
Published: June 2021

Background

The WHO has raised concerns about the psychological consequences of the current COVID-19 pandemic, negatively affecting health across societies, cultures and age-groups.

Methods

This online survey study investigated mental health, subjective experience, and behaviour (health, learning/teaching) among university students studying in Egypt or Germany shortly after the first pandemic lockdown in May 2020. Psychological assessment included stable personality traits, self-concept and state-like psychological variables related to (a) mental health (depression, anxiety), (b) pandemic threat perception (feelings during the pandemic, perceived difficulties in describing, identifying, expressing emotions), (c) health (e.g., worries about health, bodily symptoms) and behaviour including perceived difficulties in learning. Assessment methods comprised self-report questions, standardized psychological scales, psychological questionnaires, and linguistic self-report measures. Data analysis comprised descriptive analysis of mental health, linguistic analysis of self-concept, personality and feelings, as well as correlational analysis and machine learning. N = 220 (107 women, 112 men, 1 = other) studying in Egypt or Germany provided answers to all psychological questionnaires and survey items.

Results

Mean state and trait anxiety scores were significantly above the cut off scores that distinguish between high versus low anxious subjects. Depressive symptoms were reported by 51.82% of the student sample, the mean score was significantly above the screening cut off score for risk of depression. Worries about health (mental and physical health) and perceived difficulties in identifying feelings, and difficulties in learning behaviour relative to before the pandemic were also significant. No negative self-concept was found in the linguistic descriptions of the participants, whereas linguistic descriptions of feelings during the pandemic revealed a negativity bias in emotion perception. Machine learning (exploratory) predicted personality from the self-report data suggesting relations between personality and subjective experience that were not captured by descriptive or correlative data analytics alone.

Conclusion

Despite small sample sizes, this multimethod survey provides important insight into mental health of university students studying in Egypt or Germany and how they perceived the first COVID-19 pandemic lockdown in May 2020. The results should be continued with larger samples to help develop psychological interventions that support university students across countries and cultures to stay psychologically resilient during the pandemic.
Repetitive transcranial magnetic stimulation increases the brain’s drainage efficiency in a mouse model of Alzheimer’s disease
Authors: Lin Yangyang , Jin Jian , Lv Rongke , Luo Yuan , Dai Weiping , Li Wenchang , Tang Yamei , Wang Yuling , Ye Xiaojing , Lin Wei-Jye
Published: June 2021

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with high prevalence rate among the elderly population. A large number of clinical studies have suggested repetitive transcranial magnetic stimulation (rTMS) as a promising non-invasive treatment for patients with mild to moderate AD. However, the underlying cellular and molecular mechanisms remain largely uninvestigated. In the current study, we examined the effect of high frequency rTMS treatment on the cognitive functions and pathological changes in the brains of 4- to 5-month old 5xFAD mice, an early pathological stage with pronounced amyloidopathy and cognitive deficit. Our results showed that rTMS treatment effectively prevented the decline of long-term memories of the 5xFAD mice for novel objects and locations. Importantly, rTMS treatment significantly increased the drainage efficiency of brain clearance pathways, including the glymphatic system in brain parenchyma and the meningeal lymphatics, in the 5xFAD mouse model. Significant reduction of Aβ deposits, suppression of microglia and astrocyte activation, and prevention of decline of neuronal activity as indicated by the elevated c-FOS expression, were observed in the prefrontal cortex and hippocampus of the rTMS-treated 5xFAD mice. Collectively, these findings provide a novel mechanistic insight of rTMS in regulating brain drainage system and β-amyloid clearance in the 5xFAD mouse model, and suggest the potential use of the clearance rate of contrast tracer in cerebrospinal fluid as a prognostic biomarker for the effectiveness of rTMS treatment in AD patients.
Big data insight on global mobility during the Covid-19 pandemic lockdown
Authors: Sadowski Adam , Galar Zbigniew , Walasek Robert , Zimon Grzegorz , Engelseth Per
Published: June 2021

The Covid-19 pandemic that began in the city of Wuhan in China has caused a huge number of deaths worldwide. Countries have introduced spatial restrictions on movement and social distancing in response to the rapid rate of SARS-Cov-2 transmission among its populations. Research originality lies in the taken global perspective revealing indication of significant relationships between changes in mobility and the number of Covid-19 cases. The study uncovers a time offset between the two applied databases, Google Mobility and John Hopkins University, influencing correlations between mobility and pandemic development. Analyses reveals a link between the introduction of lockdown and the number of new Covid-19 cases. Types of mobility with the most significant impact on the development of the pandemic are “retail and recreation areas", "transit stations", "workplaces" "groceries and pharmacies”. The difference in the correlation between the lockdown introduced and the number of SARS-COV-2 cases is 81%, when using a 14-day weighted average compared to the 7-day average. Moreover, the study reveals a strong geographical diversity in human mobility and its impact on the number of new Covid-19 cases.
Using nontargeted LC-MS metabolomics to identify the Association of Biomarkers in pig feces with feed efficiency
Authors: Wu Jie , Ye Yong , Quan Jianping , Ding Rongrong , Wang Xingwang , Zhuang Zhanwei , Zhou Shenping , Geng Qian , Xu Cineng , Hong Linjun , Xu Zheng , Zheng Enqin , Cai Gengyuan , Wu Zhenfang , Yang Jie
Published: June 2021

Background

Improving feed efficiency is economically and environmentally beneficial in the pig industry. A deeper understanding of feed efficiency is essential on many levels for its highly complex nature. The aim of this project is to explore the relationship between fecal metabolites and feed efficiency-related traits, thereby identifying metabolites that may assist in the screening of the feed efficiency of pigs.

Results

We performed fecal metabolomics analysis on 50 individuals selected from 225 Duroc x (Landrace x Yorkshire) (DLY) commercial pigs, 25 with an extremely high feed efficiency and 25 with an extremely low feed efficiency. A total of 6749 and 5644 m/z features were detected in positive and negative ionization modes by liquid chromatography-mass spectrometry (LC/MS). Regrettably, the PCA could not classify the the samples accurately. To improve the classification, OPLS-DA was introduced. However, the predictive ability of the OPLS-DA model did not perform well. Then, through weighted coexpression network analysis (WGCNA), we found that one module in each positive and negative mode was related to residual feed intake (RFI), and six and three metabolites were further identified. The nine metabolites were found to be involved in multiple metabolic pathways, including lipid metabolism (primary bile acid synthesis, linoleic acid metabolism), vitamin D, glucose metabolism, and others. Then, Lasso regression analysis was used to evaluate the importance of nine metabolites obtained by the annotation process.

Conclusions

Altogether, this study provides new insights for the subsequent evaluation of commercial pig feed efficiency through small molecule metabolites, but also provide a reference for the development of new feed additives.
Elucidation of the whole carotenoid biosynthetic pathway of aphids at the gene level and arthropodal food chain involving aphids and the red dragonfly
Authors: Takemura Miho , Maoka Takashi , Koyanagi Takashi , Kawase Naoki , Nishida Ritsuo , Tsuchida Tsutomu , Hironaka Mantaro , Ueda Tetsuyuki , Misawa Norihiko
Published: June 2021

Background

Aphids can be positioned as robust pest insects in farming and as ones of the model organisms for arthropods in molecular biology. Carotenoids are pigments that protect organisms from photooxidative damage caused by excessive light. Aphids were shown to possess genes of fungal origin for carotenoid biosynthesis, whereas a little knowledge was available about the functions of the genes and the biosynthetic pathway. Even carotenoid species contained in aphids were not enough understood. Main purpose of this study is to clarify these insufficient findings.

Results

The whole carotenoid biosynthetic pathway of the pea aphid (Acyrthosiphon pisum) was elucidated at the gene level, through comprehensive functional analysis of its carotenogenic genes, using Escherichia coli that synthesized carotenoid substrates, along with structural and quantitative analysis of carotenoids from various aphid species. Four genes were needed to synthesize all carotenoids accumulated in aphids from geranylgeranyl diphosphate. The tor gene mediated desaturation reaction from phytoene to 3,4-didehydrolycopene. It was revealed that a gene designated ApCrtYB3, which was considered to have functionally evolved in aphids, can convert lycopene into uncommon carotenoids with the γ-ring such as (6′S)-β,γ-carotene and γ,γ-carotene. We further demonstrated that the atypical carotenoids work as ecological indicators for estimating the food chain from aphids to predatory arthropods, and showed that aphids contributed with significant levels to the food chain from insect herbivores to several predatory arthropods, i.e., the red dragonfly (Sympetrum frequens; adults), seven-spotted ladybird (Coccinella septempunctata), and two spiders, Oxyopes sertatus and Nephila clavata. Gut microflora of the dragonfly (mature adults) was also found to include endosymbiotic bacteria such as Serratia symbiotica specific to the black bean aphid (Aphis fabae).

Conclusions

We revealed the whole carotenoid biosynthetic pathway of aphids, including functional identification of the corresponding genes. Subsequently, we showed that arthropodal food chain can be estimated using the uncommon carotenoids of aphids as ecological indicators. This result indicated that aphids made significant contributions to the food chain of several predatory arthropods including the red-dragonfly adults. Aphids are likely to be positioned as an important “phytochemicals” source for some predatory insects and arachnids, which are often active under bright sunlight.
Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in COVID-19 pandemic: a systematic review
Authors: Kurnianto Aditya , Tugasworo Dodik , Andhitara Yovita , Retnaningsih  , Ardhini Rahmi , Budiman Jethro
Published: June 2021

Introduction

Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, COVID-19 is a disease that attacks the respiratory tract, but now the clinical manifestations of COVID-19 are various, including acute ischemic stroke (AIS). Emergency surgeries such as mechanical thrombectomy (MT) for AIS must be performed without any delay even during the COVID-19 pandemic, to reduce morbidity and mortality. Besides the focus on patient’s health, the safety of healthcare workers must also be considered. The aim of the study was to evaluate and summarize the scientific literature systematically to explore MT for AIS in the COVID-19 pandemic.

Data synthesis

The independent reviewers searched the literature through 12 electronic databases, searching for articles fulfilling inclusion and exclusion criteria. The data from all included studies were presented in a summary table featuring key points of each study. The authors independently assessed the risk of bias of 15 included articles.

Conclusion

Although MT procedure has been prolonged during the pandemic, clinical outcomes and procedure-related serious adverse events have remained unchanged during the COVID-19 pandemic. The screening process and the implementation of the PCS algorithm must be performed to reduce the spread of COVID-19 infection without threatening patient safety and clinical outcomes. The standard precaution of infection and the health assurance of healthcare workers and their families (including mental health) are also important factors that must be given special attention and consideration in the COVID-19 pandemic.
Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review
Authors: Mohan Nikita , Fayyaz Muhammad Ali , del Rio Christopher , Khurana Navpreet Kaur Rajinder Singh , Vaidya Sampada Sandip , Salazar Esteban , Joyce John , Ali Amrat Ayaz
Published: June 2021

Background

The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information.

Objective

To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2.

To identify neuro-invasive pathways of COVID infection.

Methods

Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020.

Results

Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases.

Conclusion

The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.
Quality characteristics of extracted oil from the head and gills of Catfish and Titus fish
Authors: Abiona Oluseye Oladapo , Awojide Shola Hezekiah , Anifowose Adebanjo Jacob , Adegunwa Abiodun Odunlami , Agbaje Wasiu Bolade , Tayo Adeniyi Solomon
Published: June 2021

Background

The research was carried out to assess the lipid characteristics of oil extracted from the head and gills of Claris macrocephalus and Scomber scombrus.

Results

The results confirmed the presence of C16:0, C18:0, C18:1, C18:2, C18:3, C22:6 as the major fatty acids. Titus fish head (TFHD) oil had a total saturated fatty acid (TSFA) of 40.804 ± 0.002% of which C16:0 and C18:0 were the most dominant fatty acids present while the total monounsaturated fatty (TMUFA) acids present in the oil was 33.853 ± 0.001%. The total polyunsaturated fatty acid (TPUFA) content of the TFHD oil sample was found to be 25.368 ± 0.002%. The results revealed that the total unsaturated fatty acid (TUFA) present in the TFHD was higher than the TSFA. The results obtained for Titus fish gills (TFGL) oil sample followed the same trend as observed in the head sample. The results showed that the four (4) oil samples contain high level of palmitic acid (C16:0) and stearic acid (C18:0) both of which are saturated fatty acids (SFA). The main MUFA identified was C18:1 (cis-6) and ranged from 14.120 ± 0.004 to 20.418 ± 0.002% for TFHD, TFGL, CFHD, CFGL and oleic acid (C18:1) ranged from 10.297 ± 0.001 to 11.570 ± 0.003% for TFHD, TFGL, CFHD and CFGL.

Conclusions

Oils of CFHD and TFHD showed higher peroxide values indicating suitability for human consumption.
Hypervisor-assisted dynamic malware analysis
Authors: Leon Roee S. , Kiperberg Michael , Leon Zabag Anat Anatey , Zaidenberg Nezer Jacob
Published: June 2021

Malware analysis is a task of utmost importance in cyber-security. Two approaches exist for malware analysis: static and dynamic. Modern malware uses an abundance of techniques to evade both dynamic and static analysis tools. Current dynamic analysis solutions either make modifications to the running malware or use a higher privilege component that does the actual analysis. The former can be easily detected by sophisticated malware while the latter often induces a significant performance overhead. We propose a method that performs malware analysis within the context of the OS itself. Furthermore, the analysis component is camouflaged by a hypervisor, which makes it completely transparent to the running OS and its applications. The evaluation of the system’s efficiency suggests that the induced performance overhead is negligible.
Deep learning wavefront sensing and aberration correction in atmospheric turbulence
Authors: Wang Kaiqiang , Zhang MengMeng , Tang Ju , Wang Lingke , Hu Liusen , Wu Xiaoyan , Li Wei , Di Jianglei , Liu Guodong , Zhao Jianlin
Published: June 2021

Deep learning neural networks are used for wavefront sensing and aberration correction in atmospheric turbulence without any wavefront sensor (i.e. reconstruction of the wavefront aberration phase from the distorted image of the object). We compared and found the characteristics of the direct and indirect reconstruction ways: (i) directly reconstructing the aberration phase; (ii) reconstructing the Zernike coefficients and then calculating the aberration phase. We verified the generalization ability and performance of the network for a single object and multiple objects. What’s more, we verified the correction effect for a turbulence pool and the feasibility for a real atmospheric turbulence environment.
Dividend policy-performance nexus: PMG-ARDL approach
Authors: Akinlo Olayinka Olufisayo , Olayiwola John Ayobamibo
Published: June 2021

This paper examines the long run and short run link between dividend payout policy and corporate performance of quoted companies in Nigeria over the period 2001–2018. The study employs data of 80 listed companies collected from the audited financial statements of the companies and the publication of Central Bank of Nigeria. Using Pooled Mean Group-Autoregressive Distributed Lag approach, the result shows that dividend policy negatively and statistically influence performance in the short run, while in the long run the effect is positive and significant.
Adjuvant Trastuzumab Emtansine Versus Paclitaxel in Combination With Trastuzumab for Stage I HER2-Positive Breast Cancer (ATEMPT): A Randomized Clinical Trial
Authors: Tolaney Sara M. , Tayob Nabihah , Dang Chau , Yardley Denise A. , Isakoff Steven J. , Valero Vicente , Faggen Meredith , Mulvey Therese , Bose Ron , Hu Jiani , Weckstein Douglas , Wolff Antonio C. , Reeder-Hayes Katherine , Rugo Hope S. , Ramaswamy Bhuvaneswari , Zuckerman Dan , Hart Lowell , Gadi Vijayakrishna K. , Constantine Michael , Cheng Kit , Briccetti Frederick , Schneider Bryan , Garrett Audrey Merrill , Marcom Kelly , Albain Kathy , DeFusco Patricia , Tung Nadine , Ardman Blair , Nanda Rita , Jankowitz Rachel C. , Rimawi Mothaffar , Abramson Vandana , Pohlmann Paula R. , Van Poznak Catherine , Forero-Torres Andres , Liu Minetta , Ruddy Kathryn , Zheng Yue , Rosenberg Shoshana M. , Gelber Richard D. , Trippa Lorenzo , Barry William , DeMeo Michelle , Burstein Harold , Partridge Ann , Winer Eric P. , Krop Ian
Published: June 2021

PURPOSE

The ATEMPT trial was designed to determine if treatment with trastuzumab emtansine (T-DM1) caused less toxicity than paclitaxel plus trastuzumab (TH) and yielded clinically acceptable invasive disease-free survival (iDFS) among patients with stage I human epidermal growth factor receptor 2–positive (HER2+) breast cancer (BC).

METHODS

Patients with stage I centrally confirmed HER2+ BC were randomly assigned 3:1 to T-DM1 or TH and received T-DM1 3.6 mg/kg IV every 3 weeks for 17 cycles or T 80 mg/m2 IV with H once every week × 12 weeks (4 mg/kg load →2 mg/kg), followed by H × 39 weeks (6 mg/kg once every 3 weeks). The co-primary objectives were to compare the incidence of clinically relevant toxicities (CRTs) in patients treated with T-DM1 versus TH and to evaluate iDFS in patients receiving T-DM1.

RESULTS

The analysis population includes all 497 patients who initiated protocol therapy (383 T-DM1 and 114 TH). CRTs were experienced by 46% of patients on T-DM1 and 47% of patients on TH ( P = .83). The 3-year iDFS for T-DM1 was 97.8% (95% CI, 96.3 to 99.3), which rejected the null hypothesis ( P < .0001). Serially collected patient-reported outcomes indicated that patients treated with T-DM1 had less neuropathy and alopecia and better work productivity compared with patients on TH.

CONCLUSION

Among patients with stage I HER2+ BC, one year of adjuvant T-DM1 was associated with excellent 3-year iDFS, but was not associated with fewer CRT compared with TH.