bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a Visual Support Dedicated to Prognosis on Symptoms of Stress of ICU Family Members: A Before-and-After Implementation Study
Authors: Veislinger-Burelli Gabrielle , Vincent Arthur , Mallard Jeremy , Meffre Sarah , Maarek Alizée , Bonnet Sixtine , Chapelle Céline , Morel Jérome , Beuret Pascal
Published: July 2021

OBJECTIVES:

Family members commonly have inaccurate expectations of patient’s prognosis in ICU. Adding to classic oral information, a visual support, depicting day by day the evolution of the condition of the patient, improves the concordance in prognosis estimate between physicians and family members. The objective of this study was to evaluate the impact of this tool on symptoms of anxiety/depression of family members.

DESIGN:

Bicenter prospective before-and-after study.

SETTING:

A nonacademic and a university hospital.

SUBJECTS:

Relatives of consecutive patients admitted in the two ICUs.

INTERVENTIONS:

In the period “before,” family members received classic oral information, and in the period “after,” they could consult the visual support in the patient’s room. The primary endpoint was the Hospital Anxiety and Depression Scale score of relatives at day 5. Secondary outcomes were the prevalence of symptoms of anxiety (Hospital Anxiety and Depression Scale anxiety subscale score > 7) and depression (Hospital Anxiety and Depression Scale depression subscale score > 7) at day 5 and Hospital Anxiety and Depression Scale score at day 90.

MEASUREMENTS AND MAIN RESULTS:

A total of 140 patients and their referent family members were included (77 in period before and 63 after). Characteristics of patients of the two groups were similar regarding age, reason for admission, Simplified Acute Physiology Score II at admission, and Sequential Organ Failure Assessment score at day 5. At day 5, median Hospital Anxiety and Depression Scale score was 17 (9–25) before and 15 (10–22) after the implementation of the visual support (p = 0.43). The prevalence of symptoms of anxiety and depression was similar in the two groups (66.2% and 49.4% before and 68.3% and 36.5% after [not significant], respectively). At day 90, median Hospital Anxiety and Depression Scale score was 11 before (7–16) and 9 (5–16) after the implementation of the tool (p = 0.38).

CONCLUSIONS:

In this study, the use of a visual support tool dedicated to prognosis did not modify the level of stress of family members.
A New Classification of the Lateral Dermatochalasis of Upper Eyelids
Authors: Rossi Santos Silva Kennedy , Cardoso Rossi Débora , Petroianu Andy
Published: July 2021

Background:

Eyelid dermatochalasis is an abnormal distention of the upper eyelid. This article presents a new classification of the lateral dermatochalasis (LDC) of the upper eyelids, which compares the pre- and post-blepharoplasty results and matches its results with those of the well-established Jacobs classification (JEC).

Methods:

LDC classification includes four degrees: grade zero—absence of dermatochalasis; grade 1—lower edge of dermatochalasis above the intersection of the lacrimal caruncle with the edge of the upper eyelid; grade 2—between the intersection of the lacrimal caruncle with the edge of the upper eyelid and the lower edge of the iris at the pupillary midpoint; and grade 3—lower edge of dermatochalasis below the lower edge of the iris. This study was conducted in 100 dermatochalasis cases in patients between 38 and 79 years of age (mean = 59.3) and submitted to upper blepharoplasty.

Results:

No statistically significant association was found between the LDC and JEC methods (P = 0.583). In both classifications, the eyelid dermatochalasis was reduced after blepharoplasty (P < 0.001). However, changes in the degrees of dermatochalasis before blepharoplasty were detected in 100% by LDC, and 41% by JEC. The degree of improvement of dermatochalasis observed by LDC after blepharoplasty showed greater specificity.

Conclusions:

This new classification, LDC, is specific for the lateral eyelid dermatochalasis, which is based on exact anatomical points, and is easy to perform. LDC is superior to JEC, easy to be applied, and effective and specific in detecting variations in dermatochalasis after blepharoplasty.
Trends in Corneal Transplantation in a Tertiary Hospital in Brazil
Authors: Moriyama Aline Silveira , dos Santos Forseto Adriana , Pereira Nicolas Cesário , Ribeiro Ana Cláudia , de Almeida Mateus Chaves , Figueras-Roca Marc , Casaroli-Marano Ricardo P. , Mehta Jodhbir Singh , Hofling-Lima Ana Luisa
Published: July 2021

Purpose:

The purpose of this study was to analyze the evolving trends of surgical techniques and indications of corneal transplantation (CT) at a tertiary hospital in Brazil.

Methods:

The medical records of all patients who underwent CT at the Hospital Oftalmológico de Sorocaba (Sorocaba Eye Hospital) from the Banco de Olhos de Sorocaba (Sorocaba Eye Bank) group in Sorocaba, Brazil, from January 1, 2012, to December 31, 2019, were analyzed. Data regarding age, sex, transplant indication, and surgical technique were collected.

Results:

A total of 16,250 CTs were performed. There was a statistically significant decreasing trend of keratoconus-related CT (P< 0.0001), with rates dropping from 41.7% among all CTs in 2012 to 25.5% in 2019. Penetrating keratoplasty, anterior lamellar keratoplasty, and endothelial keratoplasty (EK) accounted for 59.3%, 27.1%, and 7.8% of the CTs performed in 2012 and 33.3%, 16.4%, and 39.9% in 2019, respectively. A statistically significant decreasing trend was observed for penetrating keratoplasty (P< 0.0001) and anterior lamellar keratoplasty (P< 0.0001), whereas EK showed a statistically significant increasing trend during the period (P< 0.0001). Among EKs, Descemet membrane EK increased statistically significantly from 12.8% in 2012 to 74.4% in 2019 (P< 0.0001).

Conclusions:

This study shows relevant evolving trends in indications and preferred CT techniques in a tertiary hospital in Brazil.
Progression of Pediatric Keratoconus After Corneal Cross-Linking: A Systematic Review and Pooled Analysis
Authors: Achiron Asaf , El-Hadad Omar , Leadbetter Duncan , Hecht Idan , Hamiel Uri , Avadhanam Venkata , Tole Derek , Darcy Kieren
Published: July 2021

Purpose:

Corneal collagen cross-linking (CXL) is an effective treatment to slow down keratoconus (KC) progression in adults. Several studies have also shown efficacious outcomes in pediatric populations, yet no systematic analysis has been performed and no accepted definition for progression is available in children after CXL. This study aimed to establish the most commonly used criteria for progression and to conduct a systematic review of the literature with pooled analysis to assess children's keratoconus progression after CXL.

Methods:

A systemic literature review combined with pooled analysis was performed on full-length studies of KC after CXL treatment in a pediatric population and the methods used to report progression were analyzed.

Results:

Thirty-seven studies (2078 eyes) were identified on the rates of KC progression after CXL. The most common method to report progression was increased Kmax, Kmean, or Ksteep by ≥1.0 diopter (78.3% of studies). Using these criteria, the mean pooled progression rate after epithelium-off CXL was 9.9% (95% confidence interval: 6.1% –14.6%, total pooled sample size: 1508 eyes) with high heterogeneity between studies [I2 = 86.48% (95% confidence interval: 80.98 – 90.39), P < 0.0001].

Conclusions:

When considering KC progression after CXL in children, with an increase in Kmax, Kmean, or Ksteep ≥ 1.0 diopter, the progression risk was roughly 10%. We encourage clear quantitative reporting of KC progression in future studies evaluating CXL efficacy in pediatric populations.
Double Frost Suture Technique for Simultaneous Skin Grafting of the Upper and Lower Eyelids
Authors: DeMaria Lauren N. , Tran Ann Q. , Tooley Andrea A. , North Victoria S. , Flores Roberto L. , Lisman Richard D. , Belinsky Irina
Published: July 2021

The double Frost suture is a useful supplement to the reconstruction of ipsilateral upper and lower eyelid defects with full-thickness skin grafts. This technique involves silk traction sutures that overlap the upper and lower eyelids to place them on maximal stretch after placement of 2 full-thickness skin grafts. It has the added benefit of protecting the cornea and compressing both grafts under 1 bolster. The authors illustrate this technique in 2 pediatric cases—a congenital melanocytic kissing eyelid nevus and a periocular burn. Each case resulted in large upper and lower anterior lamellar defects, which were reconstructed with supraclavicular and retroauricular free skin grafts. The double Frost sutures counter vertical cicatricial forces during graft healing, obviating the need for staged procedures. Both described cases resulted in excellent graft survival with minimal contracture.
Acute Care Rehabilitation Following Upper and Lower Extremity Free Flap Surgery: A Review of Best Practices and Case Reports
Authors: Fufa Duretti , Osei Daniel , Antonietti Samantha , Keaney Kathryn
Published: July 2021

Purpose:

The purpose of this article is to highlight the guiding principles and protocols for immediate and early postoperative management of upper and lower extremity flaps. We review critical principals of flap monitoring, dangling protocols, splinting, and positioning, as they relate to the physical and occupational therapists' acute care of patients following flap surgery. We refer to the protocol used at our facility but also discuss other protocols used in different hospitals.

Case Demonstrations:

Two cases have been discussed in this article, one involving the upper extremity and the other involving the lower extremity. The first case is a 43-year-old man who fell on the subway tracks, resulting in severe electrical burns requiring an anterolateral thigh flap for soft tissue coverage of exposed bone. The second case is a 55-year-old patient who was involved in a motor vehicle accident resulting in an open knee wound requiring a free latissimus dorsi muscle transfer for soft tissue coverage.

Conclusion:

There is no “gold standard” when treating a patient after flap surgery. As therapists, after a bed rest order is lifted, we initiate mobilizing a patient. Therefore, we may be present when a flap is at risk for compromise. As such, therapists should become familiar with the surgeon's protocol at their facility and understand how to appropriately progress patients. Additionally, a therapist should comprehend ways to assess a flap and familiarize themselves with principles of flap management.
Using Routinely Collected Electronic Health Record Data to Predict Readmission and Target Care Coordination
Authors: Omary Courtney , Wright Phyllis , Kumarasamy Mathu A. , Franks Nicole , Esper Gregory , Mouzon Helen B. , Barrolle Shimika , Horne Kandra , Cranmer John
Published: July 2021

Patients with chronic renal failure (CRF) are at high risk of being readmitted to hospitals within 30 days. Routinely collected electronic health record (EHR) data may enable hospitals to predict CRF readmission and target interventions to increase quality and reduce readmissions. We compared the ability of manually extracted variables to predict readmission compared with EHR-based prediction using multivariate logistic regression on 1 year of admission data from an academic medical center. Categorizing three routinely collected variables (creatinine, B-type natriuretic peptide, and length of stay) increased readmission prediction by 30% compared with paper-based methods as measured by C-statistic (AUC). Marginal effects analysis using the final multivariate model provided patient-specific risk scores from 0% to 44.3%. These findings support the use of routinely collected EHR data for effectively stratifying readmission risk for patients with CRF. Generic readmission risk tools may be evidence-based but are designed for general populations and may not account for unique traits of specific patient populations—such as those with CRF. Routinely collected EHR data are a rapid, more efficient strategy for risk stratifying and strategically targeting care. Earlier risk stratification and reallocation of clinician effort may reduce readmissions. Testing this risk model in additional populations and settings is warranted.
The Effect of Sodium Thiosulfate on Coronary Artery Calcification in Hemodialysis Patients
Authors: Bian Zhixiang , Zhang Qin , Shen Li , Feng Yanping , Chen Shunjie
Published: July 2021

This study aimed to effectively control the disease process of hemodialysis outpatients. Hemodialysis secondary hyperparathyroidism patients were randomly divided into the control group and treatment group. The control group was treated with routine treatment, and the treatment group was treated with sodium thiosulfate based on the control group. The changes of serum calcium, phosphorus, whole parathyroid hormone, calcium-phosphorus product and coronary artery calcification (CAC) score, as well as the relief of clinical symptoms, postoperative complications and recurrence in the preoperative and postoperative periods were observed. The levels of C-reactive protein and CAC scores were significantly decreased in the treatment group after treatment. While there was no significant difference in blood calcium, blood phosphorus, PTH, calcium-phosphorus product, and CAC score in the control group after treatment. And after treatment, the proportion of skin pruritus, myasthenia, bone pain, insomnia, restless legs syndrome, and other symptoms in the treatment group was significantly decreased compared with those before treatment, but there was no significant change in the control group before and after treatment. Sodium thiosulfate can reduce the high level of CAC in hemodialysis patients obviously.
Devastating Postpartum Complications in an Adolescent Linked to New-Onset Inflammatory Bowel Disease and Antiphospholipid Antibody Syndrome
Authors: Rao Anita , Runde Joseph , Olivas Andrea D. , Patton Tiffany
Published: July 2021

Pregnancy can affect the severity of inflammatory bowel disease (IBD), and pregnant women with IBD are at a higher risk for venous thromboembolism compared with the general population. We report a previously healthy 16-year-old female who developed bloody diarrhea and venous thromboembolism following childbirth, with further evaluation revealing IBD and antiphospholipid antibody syndrome. This case highlights the impact pregnancy can have on IBD and other immunological disorders, and the potentially life-threatening risk of thrombosis in pregnant women with IBD.
Gastrointestinal Basidiobolomycosis in a Child: Unusual Fungal Infection Mimicking Eosinophilic Gastrointestinal Diseases—A Case Report and Review of the Literature
Authors: Al Harthy Fat’hiya , Al Kalbani Omaima , Al Masqri Mohammed , Al Dhuhli Ahmed , Al Said Khoula
Published: July 2021

Gastrointestinal basidiobolomycosis (GIB) is unusual, rare, and emerging fungal infection. It is caused by Basidiobolus ranarum. Unlike other fungal infections, B ranarum affects immunocompetent individuals with potentially grave sequelae if unrecognized. GIB is difficult to be diagnosed due to unspecific clinical presentation. Diagnosis of basidiobolomycosis requires culture of B ranarum from tissue. Optimal management of GIB includes antifungal therapy alongside if necessary early surgery.
Effective Use of Topical Sucralfate in the Conservative Management of Expanded Gastrostomy Tract Reduction
Authors: Zheng Hengqi Betty , Len Mary , Pattamanuch Nicole
Published: July 2021

Sucralfate is a common medication used to treat duodenal ulcers, gastric ulcers, and gastritis. The off-label use of topical sucralfate has been described in the literature to induce wound healing in epithelial injury. Yet, current literature lacks clinical depictions in the application of sucralfate to treat a common gastrostomy tube complication, that of a dilated gastrostomy site. We present a case report of a medically complex pediatric patient where topical sucralfate was applied to reduce the size of a large gastrostomy stomal defect. Sucralfate was used to reduce healing time and allow introduction of a new gastrostomy device through the same stomal opening without the need for additional procedures or surgeries.
Axial Spondyloarthritis in the Chiropractic Care Setting
Authors: Deodhar Atul , Kiwalkar Sonam , Mehendale Teja , Bhalerao Shireesh
Published: July 2021

Diagnosis of axial spondyloarthritis (axSpA), an immune-mediated inflammatory disease, is commonly associated with chronic inflammatory back pain (IBP) and often occurs years after initial onset of clinical symptoms. Recognition of IBP is important for timely referral of patients with suspected axSpA to a rheumatologist. Patients with all types of back pain are treated in chiropractic care, but the proportion of patients with undiagnosed axSpA is unknown. This systematic literature review investigated the presence of axSpA in patients treated by chiropractors and identified the chiropractor's role in axSpA diagnosis, referral, and management. A PubMed search was conducted using the following search strings: “chiropract*” AND (“sacroiliac” OR “back pain” OR “spondyloarthritis” OR “ankylosing spondylitis”); English language, since 2009; and (chiropractic OR chiropractor) AND (ankylosing spondylitis OR axial spondyloarthritis), with no date limits. Of 652 articles identified in the searches, 27 met the inclusion criteria. Although back pain was identified as a common reason for patients seeking chiropractic care, there was no mention of axSpA, ankylosing spondylitis, or the distinction between mechanical and IBP. Data from relevant articles suggested that the majority of patients seeking chiropractic care have lower back pain, whereas no articles reported axSpA in this patient population. The near absence of any identified articles on axSpA in chiropractic care may be due to underrecognition of axSpA, resulting in delayed rheumatology referral and appropriate management. Better awareness and increased use of validated screening tools could reduce diagnostic delay of axSpA in chiropractic care.
The Pattern of Change in Depressive Symptoms and Inflammatory Markers After Electroconvulsive Therapy
Authors: Desfossés Charles-Yoland , Peredo Rossana , Chabot Andréane , Carmel Jean-Philippe , Tremblay Pierre-Marc , Mérette Chantal , Picher Geneviève , Lachance Isabelle , Patry Simon , Lemasson Morgane
Published: July 2021

Depression is a major mental health disorder, and its pathophysiology is still largely unknown, as is the action mechanism of electroconvulsive therapy (ECT). Some evidence suggests that inflammation might play a role in depression, and several studies have attempted to demonstrate a link between ECT and cytokines. This systematic review used a qualitative analysis to assess the effect of ECT on inflammatory markers as it relates to the clinical response of depressive symptoms in major depressive disorders. The bibliographic search engines CINAHL, Embase, PsychInfo, and PubMed were used to identify articles published up to July 2020. Search terms related to depression, ECT, and inflammation were used. Descriptive statistical analyses were performed to relate changes in inflammatory markers to clinical response to ECT. Twenty-five studies were included in the analysis. No systematic increases or decreases were found in a given inflammatory marker over the ECT; however, we observed that tumor necrosis factor α and interleukin-6 (IL-6) were more often found to be decreased after ECT, whereas IL-8 and IL-10 were more often found to be increased after treatment. No trend in correlation was found between the degree of clinical improvement of depressive symptoms and the variation of any inflammatory markers, despite positive clinical response to ECT. Great heterogeneity with regard to methodology used and lack of power of the studies included in this review could explain the lack of systematic change and correlation found in this study. Future research conducted on this subject should take into account these methodological limitations to allow subsequent meta-analysis.
Physiological and genomic features of Henriciella with the description of Henriciella mobilis sp. nov.
Authors: Ren Wen-Ting , Cheng Hong , Wang Chun-Sheng , Xu Xue-Wei , Zhou Peng , Wu Yue-Hong
Published: July 2021

Strains M65T, M69 and JN25 were isolated from seawater of the West Pacific Ocean. Cells of the three strains were Gram-stain-negative, aerobic and rod-shaped. Cells were motile by means of flagella. On the basis of the results of 16S rRNA gene sequence analysis, strains M65T, M69 and JN25 showed the highest 16S rRNA gene sequence similarity to

Henriciella algicola

MCS27T (98.8 %), followed by

Henriciella marina

DSM 19595T (98.4 %),

Henriciella barbarensis

MCS23T (98.4 %),

Henriciella pelagia

LA220T (98.3 %),

Henriciella aquimarina

P38T (98.1 %) and

Henriciella litoralis

SD10T (97.8 %). The 16S rRNA gene sequence similarities among the isolates were 100 %. Phylogenetic analyses revealed that the isolates fell within a cluster comprising the

Henriciella

species and represented an independent lineage. The average nucleotide identity and in silico DNA–DNA hybridization values between strain M65T and the type strains of

Henriciella

species were 73.9–85.8 % and 19.9–22.4 %, respectively. The sole respiratory quinone detected in the three isolates was ubiquinone 10. The principal fatty acids were summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c) and C16 : 0. The major polar lipids were glucuronopyranosyldiglyceride, monoglycosyldiglyceride and one unidentified glycolipid. The DNA G+C content was 61.3–61.4 mol%. Phylogenetic distinctiveness, chemotaxonomic differences, together with phenotypic properties, revealed that the isolates could be differentiated from the

Henriciella

species with validly published names. Therefore, it is proposed that strains M65T, M69 and JN25 represent a novel species of the genus

Henriciella

, for which the name Henriciella mobilis sp. nov. (type strain, M65T=CGMCC 1.15927T=KCTC 52576T) is proposed.
Chitinibacter bivalviorum sp. nov., isolated from the gut of the freshwater mussel Anodonta arcaeformis
Authors: Choi Jee-Won , Lee Jae-Yun , Hyun Dong-Wook , Lee June-Young , Kim Pil Soo , Han Jeong Eun , Jeong Yun-Seok , Lee So-Yeon , Sung Hojun , Tak Euon Jung , Kim Hyun Sik , Bae Jin-Woo
Published: July 2021

A novel Gram-stain-negative, aerobic, rod-shaped bacterium with a single polar flagellum, designated strain 2T18T, was isolated from the gut of the freshwater mussel Anodonta arcaeformis collected in the Republic of Korea. Phylogenetic analyses based on 16S rRNA gene sequences showed that the strain belonged to the genus

Chitinibacter

. Strain 2T18T formed a monophyletic clade with

Chitinibacter fontanus

KCTC 42982T,

C. tainanensis

KACC 11706T and

C. alvei

KCTC 23839T, with sequence similarities of 98.5, 98.4 and 95.9 %, respectively. Strain 2T18T exhibited optimal growth at 30 °C, at pH 8 and with 0.5 % (w/v) NaCl. The major isoprenoid quinone was ubiquinone-8 (Q-8). The predominant fatty acids were summed feature 3 (C16 : 1
ω6c and/or C16 : 1
ω7c) and C16 : 0. The polar lipids comprised phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, one unidentified lipid, three unidentified phospholipids and two unidentified aminophospholipids. The G+C content of the genomic DNA was 50.6 mol%. The average nucleotide identity and digital DNA–DNA hybridization values between strains 2T18T and

C. fontanus

KCTC 42982T were below the thresholds used for the delineation of a novel species. Based on the phylogenetic, phenotypic, chemotaxonomic and genotypic characteristics, strain 2T18T represents a novel species of the genus

Chitinibacter

, for which the name Chitinibacter bivalviorum sp. nov. is proposed. The type strain is 2T18T (=KCTC 72821T=CCUG 74764T).
Shigella escapes lysosomal degradation through inactivation of Rab31 by IpaH4.5
Authors: Sun Jin , Wang Xiaolin , Lin Haotian , Wan Luming , Chen Ji , Yang Xiaopan , Li Dongyu , Zhang Yanhong , He Xiang , Wang Bin , Dong Mingxin , Zhong Hui , Wei Congwen
Published: July 2021

Introduction.

Shigella flexneri

is an intracellular bacterial pathogen that utilizes a type III secretion apparatus to inject effector proteins into host cells.

Hypothesis/Gap Statement. The T3SS effector IpaH4.5 is important for the virulence of

Shigella

.

Aim. This study aimed to elucidate the molecular mechanism and host target of the IpaH4.5 as well as its roles in

S. flexneri

infection.

Methodology. The GAP assay was used to identify substrate Rab GTPases of IpaH4.5. A coimmunoprecipitation assay was applied to identify the interaction of Rab GTPases with IpaH4.5. A confocal microscopy analysis was used to assess the effects of IpaH4.5 on mannose 6-phosphate receptor (MPR) trafficking. To identify the effects of IpaH4.5 GAP activity on the activity of lysosomal cathepsin B, the Magic Red-RR assay was used. Finally, the intracellular persistence assay was used to identify IpaH4.5 GAP activity in

S. flexneri

intracellular growth.

Results. We found that the effector IpaH4.5 disrupts MPR trafficking and lysosomal function, thereby counteracting host lysosomal degradation. IpaH4.5 harbours TBC-like dual-finger motifs and exhibits potent RabGAP activities towards Rab31. IpaH4.5 disrupts the transport of the cation-dependent mannose 6-phosphate receptor (CD-MPR) from the Golgi to the endosome by targeting Rab31, thereby attenuating lysosomal function. As a result, the intracellular persistence of

S. flexneri

requires IpaH4.5 TBC-like GAP activity to mediate bacterial escape from host lysosome-mediated elimination.

Conclusion. We identified an unknown function of IpaH4.5 and its potential role in

S. flexneri

infection.
Antibody titers measured by commercial assays are correlated with neutralizing antibody titers calibrated by international standards
Authors: Kung Yu-An , Huang Chung-Guei , Huang Sheng-Yu , Liu Kuan-Ting , Huang Peng-Nien , Yu Kar-Yee , Yang Shu-Li , Chen Chia-Pei , Cheng Ching-Yun , Lin Yueh-Te , Liu Yen-Chin , Chen Guang-Wu , Shih Shin-Ru
Published: July 2021

The World Health Organization (WHO) has highlighted the importance of an international standard (IS) for SARS-CoV-2 neutralizing antibody titer detection, with the aim of calibrating different diagnostic techniques. In this study, IS was applied to calibrate neutralizing antibody titers (IU/mL) and binding antibody titers (BAU/mL) in response to SARS-CoV-2 vaccines. Serum samples were collected from participants receiving the Moderna (n = 20) and Pfizer (n = 20) vaccines at three time points: pre-vaccination, after one dose, and after two doses. We obtained geometric mean titers of 1404.16 and 928.75 IU/mL for neutralizing antibodies after two doses of the Moderna and Pfizer vaccines, respectively. These values provide an important baseline for vaccine development and the implementation of non-inferiority trials. We also compared three commercially available kits from Roche, Abbott, and MeDiPro for the detection of COVID-19 antibodies based on binding affinity to S1 and/or RBD. Our results demonstrated that antibody titers measured by commercial assays are highly correlated with neutralizing antibody titers calibrated by IS.
How an election can be safely planned and conducted during a pandemic: Decision support based on a discrete event model
Authors: Weibrecht Nadine , Rößler Matthias , Bicher Martin , Emrich Štefan , Zauner Günther , Popper Niki
Published: July 2021

In 2020, the ongoing COVID-19 pandemic caused major limitations for any aspect of social life and in specific for all events that require a gathering of people. While most events of this kind can be postponed or cancelled, democratic elections are key elements of any democratic regime and should be upheld if at all possible. Consequently, proper planning is required to establish the highest possible level of safety to both voters and scrutineers. In this paper, we present the novel and innovative way how the municipal council and district council elections in Vienna were planned and conducted using an discrete event simulation model. Key target of this process was to avoid queues in front of polling stations to reduce the risk of related infection clusters. In cooperation with a hygiene expert, we defined necessary precautions that should be met during the election in order to avoid the spread of COVID-19. In a next step, a simulation model was established and parametrized and validated using data from previous elections. Furthermore, the planned conditions were simulated to see whether excessive queues in front of any polling stations could form, as these could on the one hand act as an infection herd, and on the other hand, turn voters away. Our simulation identified some polling stations where long queues could emerge. However, splitting up these electoral branches resulted in a smooth election across all of Vienna. Looking back, the election did not lead to a significant increase of COVID-19 incidences. Therefore, it can be concluded that careful planning led to a safe election, despite the pandemic.

Author summary

Why was this study done?

The ongoing COVID-19-Pandemic poses a risk for elections, as these could lead to another spread of the disease.

Additional hygiene measures, which are inevitable if the election is conducted, could lead to long queues in front of the polling stations on election day.

What did the researchers do and find?

We describe the defined additional hygiene measures.

We modeled the whole election process, including the new hygiene concept, to show where extensive queues could form on the election day.

We show that thanks to the additional hygiene measures, the election actually did not cause a temporary upswing of the epidemic.

What do these findings mean?

Thanks to careful planning, it is possible to safely hold an election during such a pandemic.

Our simulation contributed to a safe and smooth election.

However, it should be stated, that these findings hold for elections in Austria, where long queues in front of polling stations are comparably rare and short.
Determinants of SARS-CoV-2 Vaccine Engagement in Algeria: A Population-based Study with Systematic Review of Studies from Arab Countries of the MENA Region
Authors: Kacimi Salah Eddine Oussama , Klouche-Djedid Selma Nihel , Riffi Omar , Belaouni Hadj Ahmed , Yasmin Farah , Taouza Fatma Asma , Belakhdar Yasmine , Fellah Saliha Chiboub , Benmelouka Amira Yasmine , Ahmed Shoaib , Aloulou Mohammad , Bendelhoum Abdellah , Merzouk Hafida , Ghozy Sherief , Essar Mohammad Yasir , Haireche Mohamed Amine
Published: July 2021

Background

The Algerian COVID-19 vaccination campaign, which started by the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement towards the COVID-19 vaccine among the Algerian population.

Methods

A nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement versus nonengagement. Sociodemographic and clinical data, perceptions about COVID-19 and levels of adherence to preventive measures were analyzed as predictors for nonengagement.

Results

We included 1,019 participants, 54% were female and 64% were aged 18-29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region (p>0.05). Nonengagement was independently associated with female gender (OR=2.31, p<0.001), low adherence level to preventive measures (OR=6.93p<0.001), private sector jobs (OR=0.53, p=0.038), perceived COVID-19 severity (OR=0.66, p=0.014), and fear from contracting the disease (OR=0.56, p=0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%.

Conclusions

The very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.
Predicting Managers’ Mental Health Across Countries Using Country-Level COVID-19 Statistics
Authors: Li Lun , Zhang Stephen X. , Graf-Vlachy Lorenz
Published: July 2021

Background

There is limited research focusing on publicly available statistics on the Coronavirus disease 2019 (COVID-19) pandemic as predictors of mental health across countries. Managers are at risk of suffering from mental disorders during the pandemic because they face particular hardship.

Objective

We aim to predict mental disorder (anxiety and depression) symptoms of managers across countries using country-level COVID-19 statistics.

Methods

A two-wave online survey of 406 managers from 26 countries was finished in May and July 2020. We used logistic panel regression models for our main analyses and performed robustness checks using ordinary least squares regressions. In the sample of 406 managers from 26 countries, 26.5% of managers reached the cut-off levels for anxiety (General Anxiety Disorder-7; GAD-7) and 43.5% did so for depression (Patient Health Questionnaire-9; PHQ-9) symptoms.

Findings

We found that cumulative COVID-19 statistics (e.g., cumulative cases, cumulative cases per million, cumulative deaths, and cumulative deaths per million) predicted managers’ anxiety and depression symptoms positively, whereas daily COVID-19 statistics (daily new cases, smoothed daily new cases, daily new deaths, smoothed daily new deaths, daily new cases per million, and smoothed daily new cases per million) predicted anxiety and depression symptoms negatively. In addition, the reproduction rate was a positive predictor, while stringency of governmental lockdown measures was a negative predictor. Individually, we found that the cumulative count of deaths is the best single predictor of both anxiety and depression symptoms.

Conclusions

Cumulative COVID-19 statistics predicted managers’ anxiety and depression symptoms positively, while non-cumulative daily COVID-19 statistics predicted anxiety and depression symptoms negatively. Cumulative count of deaths is the best single predictor of both anxiety and depression symptoms. Reproduction rate was a positive predictor, while stringency of governmental lockdown measures was a negative predictor.
Maternal Urinary Phthalate Metabolites are Associated with Lipidomic Signatures Among Pregnant Women in Puerto Rico
Authors: Ashrap Pahriya , Aung Max T. , Watkins Deborah J. , Mukherjee Bhramar , Rosario-Pabón Zaira , Vélez-Vega Carmen M. , Alshawabkeh Akram , Cordero José F. , Meeker John D.
Published: July 2021

Background

Phthalates have been reported to alter circulating lipid concentrations in animals, and investigation of these associations in humans will provide greater understanding of potential mechanisms for health outcomes.

Objective

to explore associations between phthalate metabolite biomarkers and lipidomic profiles among pregnant women (n = 99) in the Puerto Rico PROTECT cohort.

Methods

We measured 19 urinary phthalate metabolites during 24-28 weeks of pregnancy. Lipidomic profiles were identified from plasma samples by liquid chromatography-mass spectrometry-based shotgun lipidomics. Relationships between phthalates and lipid profiles were estimated using compound-by-compound comparisons in multiple linear regression and dimension reduction techniques. We derived sums for each lipid class and sub-class (saturated, monounsaturated, polyunsaturated) which were then regressed on phthalates. Associations were adjusted for false discovery.

Results

After controlling for multiple comparisons, 33 phthalate-lipid associations were identified (q-value<0.05), and diacylglycerol 40:7 and plasmenyl-phosphatidylcholine 35:1 were the most strongly associated with multiple phthalate metabolites. Metabolites of di-2-ethylhexyl phthalate, bis(2-ethylhexyl) phthalate, dibutyl phthalates, and diisobutyl phthalate were associated with increased ceramides, lysophosphatidylcholines, lysophosphatidylethanolamines, and triacylglycerols, particularly those containing saturated and monounsaturated fatty acid chains.

Significance

Characterization of associations between lipidomic markers and phthalates during pregnancy will yield mechanistic insight for maternal and child health outcomes.

Impact Statement

This study leverages emerging technology to evaluate lipidome-wide signatures of phthalate exposure during pregnancy. Circulating lipids are critical for biological processes including inflammation, cell-to-cell communication, and metabolism. Therefore, lipid signatures of phthalate exposure provide insight into potential toxicological mechanisms. Characterization of these mechanisms are relevant for informing the etiology of maternal and children’s health outcomes.
The efficacy of vaccines in the context of SARS-CoV-2 and its variants: Role of Spatio-temporal boundary
Authors: Roy Durbar , Chakravortty Dipshikha , Basu Saptarshi
Published: July 2021

The preference for a COVID-19 vaccine, among many available, may be difficult for common people and normally relies on efficacy values reported from clinical trials. Vaccine efficacy depends on statistical data from primary and secondary endpoints of a trial. This study provides a time-varying mathematical framework that compares two vaccines of contrasting efficacy (Pfizer-BioNTech and AstraZeneca-Oxford) using hypothetical trials with real-world data. Modeling shows that efficacies can fluctuate depending on the prevailing infection rate and demographics. The efficacy of AstraZeneca-Oxford can become comparable and even better than Pfizer-BioNTech, depending on the region and time of the clinical trials. We also introduce an idea of composite efficacy considering multi-variants and show that the efficacy of various vaccines shows differential sensitivity to the delta variant rampant in India.
Cognitive profile of mild behavioral impairment in Brain Health Registry participants
Authors: Kassam F. , Chen H. , Nosheny R.L. , McGirr A. , Williams T. , Ng Nicole , Camacho Monica , Mackin R.S. , Weiner M.W. , Ismail Z.
Published: July 2021

INTRODUCTION

Dementia assessment includes cognitive and behavioral testing with informant validation. Conventional testing is resource intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. We interrogated the relationship between informant-rated behavioral changes and neuropsychological test performance in older adults in the Brain Health Registry.

METHODS

Participants completed online unsupervised cognitive tests, and informants completed the Mild Behavioral Impairment Checklist via a Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity.

RESULTS

Mean age of the 499 participants was 67, 61% of which were female. MBI+ participants had lower working memory and executive function test scores. Lower cognitive test scores associated with greater MBI burden.

DISCUSSION

Our findings support the feasibility of remote, informant-reported behavioral assessment and support its validity by demonstrating a relationship to cognitive test performance using online unsupervised assessments for dementia risk assessment.

RESEARCH IN CONTEXT

Systematic review

The authors searched MEDLINE and Google Scholar for studies linking Mild Behavioral Impairment (MBI) and cognition in non-demented older adults. Most studies have utilized transformed Neuropsychiatric Inventory scores to assess MBI, and relatively few using the novel MBI-checklist (MBI-C), with the largest study using self-report. Exploration of informant reports of MBI is important due to impaired insight that may accompany neuropsychiatric symptoms.

Interpretation

Older adults with online, informant reported MBI had poorer performance in memory and executive function measured using online neuropsychological testing compared to those without MBI. These findings are consistent with the current literature and suggest that the MBI-C may serve as a marker for poorer cognitive performance.

Future directions

Our data support the role of online testing of cognition and behavior for risk assessment. This approach to evaluate behavior and cognition can be explored further, to determine if it is a scalable, online approach to detection of neurodegenerative disease.
Dissecting Biological Pathways of Psychopathology using Cognitive Genomics
Authors: Lam Max , Chen Chia-Yen , Hill W. David , Xia Charley , Tian Ruoyu , Levey Daniel F. , Gelernter Joel , Stein Murray B. , team Biogen Biobank , Hatoum Alexander S. , Huang Hailiang , Malhotra Anil K. , Runz Heiko , Ge Tian , Lencz Todd
Published: July 2021

Cognitive deficits are known to be related to most forms of psychopathology. Here, we perform local genetic correlation analysis as a means of identifying independent segments of the genome that show biologically interpretable pleiotropic associations between cognitive dimensions and psychopathology. We identified collective segments of the genome, which we call “meta-loci”, that showed differential pleiotropic patterns for psychopathology relative to either General Cognitive Ability (GCA) or Non-Cognitive Skills (NCS). We observed that neurodevelopmental gene sets expressed during the prenatal-early childhood predominated in GCA-relevant meta-loci, while post-natal synaptic gene sets were more involved in NCS-relevant meta-loci. Notably, we found that GABA-ergic, cholinergic, and glutamatergic genes drove pleiotropic relationships within dissociable NCS meta-loci.
Will a natural collective immunity of Ukrainians restrain new COVID-19 waves?
Authors: Nesteruk Igor
Published: July 2021

The visible and real sizes the COVID-19 epidemic in Ukraine were estimated with the use of the number of laboratory-confirmed cases (accumulated in May and June 2021), the generalized SIR-model and the parameter identification procedure taking into account the difference between registered and real number of cases. The calculated optimal value of the visibility coefficient shows that most Ukrainians have already been infected with the coronavirus, and some more than once, i.e., Ukrainians have probably achieved a natural collective immunity. Nevertheless, a large number of new strains and short-lived antibodies can cause new pandemic waves. In particular, the beginning of such a wave, we probably see in Ukraine in mid-July 2021. The further dynamics of the epidemic and its comparison with the results of mathematical modeling will be able to answer many important questions about the natural immunity and effectiveness of vaccines.
The role of IT ambidexterity, digital dynamic capability and knowledge processes as enablers of patient agility: an empirical study
Authors: van de Wetering Rogier , Versendaal Johan
Published: July 2021

There is a limited understanding of IT’s role as a crucial enabler of patient agility and the department’s ability to respond to patient’s needs and wishes adequately. This study’s objective is to contribute to the insights of the validity of the hypothesized relationship between IT resources, practices and capabilities, and hospital departments’ knowledge processes and the department’s ability to adequately sense and respond to patient needs and wishes, i.e., patient agility. This study conveniently sampled data from 107 clinical hospital departments in the Netherlands and uses structural equation modeling for model assessment. IT ambidexterity positively enhances the development of a digital dynamic capability. Likewise, IT ambidexterity also positively impacts the hospital department’s knowledge processes. Both digital dynamic capability and knowledge processes positively influence patient agility. IT ambidexterity promotes taking advantage of IT resources and experiments to reshape patient services and enhance patient agility.
The impact of premature extrauterine exposure on infants’ stimulus-evoked brain activity across multiple sensory systems
Authors: Mellado Gabriela Schmidt , Pillay Kirubin , Adams Eleri , Alarcon Ana , Andritsou Foteini , Cobo Maria M , Fry Ria Evans , Fitzgibbon Sean , Moultrie Fiona , Baxter Luke , Slater Rebeccah
Published: July 2021

Prematurity can result in widespread neurodevelopmental impairment, with the impact of premature extrauterine exposure on brain function detectable in infancy. A range of neurodynamic and haemodynamic functional brain measures have previously been employed to study the neurodevelopmental impact of prematurity, with methodological and analytical heterogeneity across studies obscuring how multiple sensory systems are affected. Here, we outline a standardised template analysis approach to measure the evoked response magnitudes for visual, tactile, and noxious stimulation within individual infants (n=15) using EEG. By studying a cohort of very preterm infants longitudinally (n=10), we observe that the evoked response template magnitudes are significantly associated with age-related maturation. In a subsequent cross-sectional study, we observe significant differences in visual and tactile response template magnitudes between infants born in the very preterm and late preterm periods (n=10 and 8), age-matched at study. These findings demonstrate the significant impact of premature extrauterine exposure on brain function and suggest that prematurity can accelerate maturation of the visual and tactile sensory system in infants born very prematurely. This study highlights the value of using a standardised multi-modal evoked-activity analysis approach to assess premature neurodevelopment, and will likely complement resting-state EEG and behavioural assessments in the study of the functional impact of developmental care interventions.

Highlights

Multi-modal sensory stimulation is used to assess premature infant brain function

A template analysis approach is outlined for multi-modal stimulus-evoked EEG activity

Stimulus-evoked template magnitudes change with age

Prematurity results in accelerated maturation of visual and tactile sensory systems