bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten‐year attrition and antiretroviral therapy response among HIV‐positive adults: a sex‐based cohort analysis from eight West African countries
Authors: Tiendrebeogo Thierry , Messou Eugène , Arikawa Shino , Ekouevi Didier K , Tanon Aristophane , Kwaghe Vivian , Balestre Eric , Zannou Marcel Djimon , Poda Armel , Dabis François , Jaquet Antoine , Minga Albert , Becquet Renaud ,   IeDEA West Africa Collaboration
Published: May 2021

Introduction

Sex differences have already been reported in sub‐Saharan Africa for attrition and immunological response after antiretroviral therapy (ART) initiation, but follow‐up was usually limited to the first two to three years after ART initiation. We evaluated sex differences on the same outcomes in the 10 years following ART initiation in West African adults.

Methods

We used cohort data of patients included in the IeDEA West Africa collaboration, who initiated ART between 2002 and 2014. We modelled no‐follow‐up and 10‐year attrition risks, and immunological response by sex using logistic regression analysis, survival analysis with random effect and linear mixed models respectively.

Results

A total of 71,283 patients (65.8% women) contributed to 310,007 person‐years of follow‐up in 16 clinics in eight West African countries. The cumulative attrition incidence at 10‐year after ART initiation reached 75% and 68% for men and women respectively. Being male was associated with an increased risk of no follow‐up after starting ART (5.1% vs. 4.0%, adjusted Odds Ratio: 1.25 [95% CI: 1.15 to 1.35]) and of 10‐year attrition throughout the 10‐year period following ART initiation: adjusted Hazard Ratios were 1.22 [95% CI: 1.17 to 1.27], 1.08 [95% CI: 1.04 to 1.12] and 1.04 [95% CI: 1.01 to 1.08] during year 1, years 2 to 4 and 5 to 10 respectively. A better immunological response was achieved by women than men: monthly CD4 gain was 30.2 and 28.3 cells/mL in the first four months and 2.6 and 1.9 cells/μL thereafter. Ultimately, women reached the average threshold of 500 CD4 cells/μL in their sixth year of follow‐up, whereas men failed to reach it even at the end of the 10‐year follow‐up period. The proportion of patients reaching the threshold was much higher in women than in men after 10 years since ART initiation (65% vs. 44%).

Conclusions

In West Africa, attrition is unacceptably high in both sexes. Men are more vulnerable than women on both attrition and immunological response to ART in the 10 years following ART initiation. Innovative tracing strategies that are sex‐adapted are needed for patients in care to monitor attrition, detect early high‐risk groups so that they can stay in care with a durably controlled infection.
HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia‐Pacific region: a longitudinal cohort study
Authors: Han Win Min , Jiamsakul Awachana , Salleh Nur Afiqah Mohd , Choi Jun Yong , Huy Bui Vu , Yunihastuti Evy , Do Cuong Duy , Merati Tuti P , Gani Yasmin M , Kiertiburanakul Sasisopin , Zhang Fujie , Chan Yu‐Jiun , Lee Man‐Po , Chaiwarith Romanee , Ng Oon Tek , Khusuwan Suwimon , Ditangco Rossana , Kumarasamy Nagalingeswaran , Sangle Shashikala , Ross Jeremy , Avihingsanon Anchalee ,   TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) Asia‐Pacific Group
Published: May 2021

INTRODUCTION

Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia‐Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS‐defining events and mortality among PWID receiving antiretroviral therapy (ART).

METHODS

We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load <1000 copies/mL) were assessed. Factors associated with mean CD4 changes were analysed using repeated measures linear regression, and combined AIDS event and mortality were analysed using survival analysis.

RESULTS

Of 622 PWID from 12 countries in the Asia‐Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre‐ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year‐10 (n = 78). Higher follow‐up HIV viral load and pre‐ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2‐, 5‐ and 10‐years following ART initiation. There were 52 new AIDS‐defining events and 50 deaths during 3347 person‐years of follow‐up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence <95% were associated with combined new AIDS‐defining event and death.

CONCLUSIONS

Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings.
Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017
Authors: Yohannes Nathaniel T , Jenkins Cathy A , Clouse Kate , Cortés Claudia P , Mejía Cordero Fernando , Padgett Denis , Rouzier Vanessa , Friedman Ruth K , McGowan Catherine C , Shepherd Bryan E , Rebeiro Peter F
Published: May 2021

Background

HIV incidence among women of reproductive age and vertical HIV transmission rates remain high in Latin America. We, therefore, quantified HIV care continuum barriers and outcomes among pregnant women living with HIV (WLWH) in Latin America.

Methods

WLWH (aged ≥16 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) sites from 2000 to 2017 who had HIV diagnosis, pregnancy and delivery dates contributed. Logistic regression produced adjusted odds ratios (aOR) and 95% confidence intervals (CI) for retention in care (≥2 visits ≥3 months apart) and virological suppression (viral load <200 copies/mL) 12 months after pregnancy outcome. Cumulative incidences of loss to follow‐up (LTFU) postpartum were estimated using Cox regression. Evidence of HIV status at pregnancy confirmation was the exposure. Covariates included pregnancy outcome (born alive vs. others); AIDS diagnosis prior to delivery; CD4, age, HIV‐1 RNA and cART regimen at first delivery and CCASAnet country.

Results

Among 579 WLWH, median postpartum follow‐up was 4.34 years (IQR 1.91, 7.35); 459 (79%) were HIV‐diagnosed before pregnancy confirmation, 445 (77%) retained in care and 259 (45%) virologically suppressed at 12 months of postpartum. Cumulative incidence of LTFU was 21% by 12 months and 40% by five years postpartum. Those HIV‐diagnosed during pregnancy had lower odds of retention (aOR = 0.58, 95% CI: 0.35 to 0.97) and virological suppression (aOR = 0.50, 95% CI: 0.31 to 0.82) versus those HIV‐diagnosed before.

Conclusion

HIV diagnosis during pregnancy was associated with poorer 12‐month retention and virological suppression. Young women should be tested and linked to HIV care earlier to narrow these disparities.
Using the adherence‐efficacy relationship of emtricitabine and tenofovir disoproxil fumarate to calculate background HIV incidence: a secondary analysis of a randomized, controlled trial
Authors: Glidden David V , Das Moupali , Dunn David T , Ebrahimi Ramin , Zhao Yongwu , Stirrup Oliver T , Baeten Jared M , Anderson Peter L
Published: May 2021

Introduction

Randomized trials of new agents for HIV pre‐exposure prophylaxis (PrEP) compare against emtricitabine and tenofovir disoproxil fumarate (F/TDF), without a placebo group. We used the well‐characterized adherence‐efficacy relationship for F/TDF to back‐calculate the (non‐PrEP) counterfactual background HIV incidence (bHIV) in a randomized trial of a novel PrEP agent and estimate comparative efficacy (to counterfactual bHIV).

Methods

The DISCOVER trial (ClinicalTrials.gov: NCT02842086) randomized 5387 men who have sex with men (MSM) and transgender women who have sex with men and demonstrated non‐inferiority of emtricitabine and tenofovir alafenamide (F/TAF) to F/TDF (HIV incidence rate ratio [IRR] 0·47, 95% CI: 0·19 to 1.15). Tenofovir diphosphate (TFV‐DP) levels in dried blood spots (DBS) were assessed for all diagnosed with HIV and in a random 10% of the cohort. We used a Bayesian model with a diffuse prior distribution, derived from established data relating tenofovir diphosphate levels to HIV prevention efficacy. This prior, combined with the F/TDF seroconversion rate and tenofovir diphosphate levels in DISCOVER, yielded Bayesian inferences on the counterfactual bHIV.

Results

There were six versus 11 postbaseline HIV infections (0.14 vs. 0.25/100 person‐years [PY]) on F/TAF and F/TDF respectively. Of the 11 on F/TDF, 10 had low, none had medium and one had high tenofovir diphosphate levels; among HIV‐negative controls, 5% of the person‐time years had low, 9% had medium and 86% had high TFV‐DP levels. A non‐informative prior distribution for counterfactual bHIV, combined with the prior for TFV‐DP level‐efficacy relationship, yielded a posterior counterfactual bHIV of 3·4 infections/100 PY (0.80 Bayesian credible interval [CrI] 1·9 to 5·9), which suggests a median HIV efficacy of 96% (0.95 CrI [88% to 99%]) for F/TAF and 93% (0.95 CrI [87% to 96%]) for F/TDF compared to bHIV.

Conclusions

Based on the established connection of drug concentrations to PrEP prevention efficacy, a Bayesian framework can be used to estimate a synthetic non‐PrEP control group in randomized, active‐controlled PrEP trials that include a F/TDF‐comparator group.
Preparing Leaders of Tomorrow: An Analysis of Leadership Competencies within Accredited Academic Program Learning Outcomes
Authors: Seemiller Corey
Published: May 2021

The Council for Higher Education Accreditation, U.S. Department of Education, and the Association of Specialized and Professional Accreditors provide the overarching affiliation and organization of 83 U.S. higher education academic accrediting agencies and associated 605 undergraduate and graduate academic programs. The present study explored if, and to what extent, each of the 60 Student Leadership Competencies was embedded in the language of the learning outcomes of the 605 programs. Results of a quantitative text analysis of the 36,327 learning outcomes across all 605 accredited programs show each of the competencies appearing in at least one learning outcome. The competencies of Evaluation, Verbal Communication, and Ethics emerged as the most prevalent.
Impaired intestinal function is associated with lower muscle and cognitive health and well‐being in patients with congestive heart failure
Authors: Kirschner Sarah K. , Deutz Nicolaas E. P. , Rijnaarts Iris , Smit Tiffany J. , Larsen Daniel J. , Engelen Mariëlle P. K. J.
Published: May 2021

Background

Small‐ and large‐intestinal perturbations have been described as prevalent extracardiac systemic manifestations in congestive heart failure (CHF), but alterations in protein digestion and absorption and plasma short‐chain fatty acid (SCFA) concentrations and the potential link with other systemic effects (muscle and cognitive health) have not been investigated in CHF.

Methods

We analyzed protein digestion and absorption with dual stable tracer method in 14 clinically stable, noncachectic CHF outpatients (mean left ventricular ejection fraction: 35.5% [95% CI, 30.9%–40.1%]) and 15 controls. Small‐intestinal non–carrier‐mediated permeability and active carrier‐mediated glucose transport were quantified by sugar permeability test. Plasma SCFA (acetate, propionate, butyrate, isovalerate, valerate) concentrations were measured as intestinal microbial metabolites. Muscle function was assessed by isokinetic dynamometry, cognition by a battery of tests, and well‐being by questionnaire.

Results

Protein digestion and absorption were impaired by 29.2% (P = .001) and active glucose transport by 38.4% (P = .010) in CHF. Non–carrier‐mediated permeability was not altered. Whereas plasma propionate, butyrate, and isovalerate concentrations were lower in CHF (P < .05), acetate and valerate concentrations did not differ. Overall, intestinal dysfunction was associated with impaired leg muscle quality, emotional distress, and cognitive dysfunction (P < .05).

Conclusions

We identified impaired protein digestion and absorption and altered SCFA concentrations as additional intestinal dysfunctions in CHF that are linked to reduced muscle and cognitive health and well‐being. More research is needed to implement strategies to improve intestinal function in CHF and to investigate the mechanisms underlying its link with other systemic manifestations.
Elimination of hospital‐acquired central line–associated bloodstream infection on a mixed‐service pediatric unit
Authors: Mezoff Ethan A. , Roberts Erika , Ernst Daniel , Gniadek Michelle , Beauseau Wendi , Balint Jane , Ardura Monica I. , Dienhart Molly
Published: May 2021

Introduction

Hospital‐acquired central line‐associated bloodstream infections (CLABSI) are “never events” in U.S. healthcare. National efforts to improve CLABSI rates are ongoing. Efforts are important for all patients with a central venous catheter (CVC) and critical to children with intestinal failure (IF) who depend on long‐term, daily use of a CVC and undergo extended hospitalizations. We describe outcomes of a multidisciplinary CLABSI elimination effort on a 24‐bed medical‐surgical unit caring for children with IF.

Methods

Unit CLABSI events from 1/9/2012 to 4/16/2020 were evaluated with multiple improvement interventions. We leveraged prospectively maintained clinical registries and National Healthcare Safety Network (NHSN) reporting data to extract patient and unit demographics, ethanol lock utilization, and unit CVC days. Interventions were developed utilizing expert consensus and CDC guidelines with active frontline staff engagement. Descriptive statistics and tests of non‐parametric data were employed for analysis.

Results

Ninety‐five patients with IF and 862 non‐IF patients experienced a total of 1,629 admissions with 20,372 CVC days. Twelve hospital‐acquired CLABSI events occurred during the study period, including 7 following NHSN definition change on 1/1/2015 (0.56 per 1,000 CVC days). After the last unit CLABSI on 12/5/2016, there were 7,117 CVC days through study conclusion.

Conclusions

Described interventions with an enhanced culture of collaborative care profoundly improved hospital‐acquired CLABSI occurrence. Success in a specific population translated to all other unit patients with a CVC. Findings suggest elimination is not the result of a single new product or practice, but also includes support and empowerment of those caring for the patient and their CVC.
Effect of intravenous dexamethasone on postoperative pain and swelling following periodontal flap surgery: A randomized controlled trial of patient‐centered outcomes
Authors: Vieth Michael P. , Deas David E. , Archontia Palaiologou A. , Diogenes Anibal , Mader Michael J. , Mealey Brian L.
Published: May 2021

Background

This randomized, crossover trial sought to determine if a preoperative intravenous (IV) dose of dexamethasone reduces pain, swelling, and analgesic usage following periodontal surgery.

Methods

Thirty‐seven patients planned for two similar periodontal flap surgeries under IV sedation were enrolled. Patients were randomized to receive either 2 mL (8 mg) dexamethasone sodium phosphate or 2 mL of IV solution (placebo) before the first surgery, and 2 mL of the other solution before the second surgery. Postoperative discomfort was managed with a standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen. A smartphone application was used to record self‐assessed pain and swelling scores using 21‐point numerical (NRS‐21) and 4‐point verbal (VRS‐4) rating scales as well as the number of analgesic medications taken at 12‐, 24‐, 48‐, 72‐, 168‐, and 336‐hours following each surgery.

Results

IV dexamethasone was associated with a significant reduction in pain at 12, 24, 48, and 72 hours (P <0.05), and swelling at 12, 24, 48, and 168 hours (P < 0.05) postoperatively when compared with placebo based on NRS‐21 responses. VRS‐4 data showed significant reductions in pain at 12, 72, and 168 hours and swelling at 12, 24, and 168 hours postoperatively with dexamethasone. No significant differences were found in the number of tablets of ibuprofen or acetaminophen between dexamethasone and placebo surgeries.

Conclusions

Preoperative, intravenously administered dexamethasone reduces pain and swelling within the first postoperative week following periodontal flap surgery and should be considered a useful adjunct for perioperative management.
Screening anti‐gout compounds from Phellinus igniarius by ultrafiltration liquid chromatography mass spectrometry based on evaluation of an in vitro method combined with enzymatic reaction
Authors: Wang Jing , Song Jiling , Zhang Yong , Gou Shasha , Shi Bingqing , Shi Dongfang , Zheng Meizhu , Yu Min , Liu Chun‐ming
Published: May 2021

In the present study, the anti‐inflammation effect of Phellinus igniarius extract was detected on an in vitro model of RAW 264.7 cells stimulated using sodium urate. In this cell model, the content changes of inflammatory cytokines, intercellular adhesion molecule‐1, and interleukin‐1 beta, in cell culture supernatants were detected using an enzyme‐linked immunosorbent assay. The xanthine oxidase inhibitory activity of P. igniarius extracts was determined using a microplate reader. Furthermore, in order to identify the active compounds of P. igniarius, ultrafiltration liquid chromatography mass spectrometry was utilized to screen xanthine oxidase inhibitors from the extract. Our results showed that in the presence of P. igniarius extract, the expressions of interleukin‐1 beta and intercellular adhesion molecule‐1 decreased (p < 0.01 and p < 0.05, respectively) compared to that in the control group. The extract effective inhibited the xanthine oxidase activity. Finally, seven compounds were screened and identified as potential xanthine oxidase inhibitors from P. igniarius. Taken together, these results demonstrate a potential anti‐inflammation bioactivity of P. igniarius in vitro, providing a basis for further in vivo research for the prevention and treatment of gout.
Use of 1‐octyl‐3‐methylimidazole hexafluorophosphate modified magnetic hyperbranched polyamideamine as sorbent for the extraction of pyrethroid insecticides from tea infusion
Authors: Liu Zikai , Meng Zilin , Fan Jiaxuan , Li Jing , Zhou Wenfeng , Gao Haixiang , Zhang Sanbing , Lu Runhua
Published: May 2021

Magnetic hyperbranched polyamideamine was carboxylated using succinic anhydride and modified further with 1‐octyl‐3‐methylimidazole hexafluorophosphate successively. The morphology and chemical composition of the prepared material was characterized by transmission electron microscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, Brunauer–Emmett‐Teller measurement, X‐ray photoelectron spectroscopy, etc. 1‐Octyl‐3‐methylimidazole hexafluorophosphate modified magnetic hyperbranched polyamideamine was used as sorbent in the magnetic solid‐phase extraction for the separation and enrichment of five pyrethroid insecticides from tea infusion. The magnetic solid‐phase extraction method proposed in this article has low method detection limits (0.53–0.71 ng/mL), acceptable coefficient of determination (0.9992–0.9998), wide linear ranges (2.5–500.0 ng/mL), and good repeatability (intraday: 1.2–6.3%; interday: 1.6–5.4%). In the detection of five pyrethroid insecticides in tea infusion, relative recoveries were in the range from 87.7 to 114.7% with satisfactory relative standard deviations (0.2–7.4%). With the aid of quantum chemistry calculations, the interaction energy between the sorbent and five pyrethroid insecticides was calculated, which proved the necessity of the modification of 1‐octyl‐3‐methylimidazole hexafluorophosphate.
Pre‐tracheotomy for Potentially Emergent Airway Scenarios: Indications and Outcomes
Authors: Knewitz Allison , Nanda Nainika , Hoffman Matthew R. , Dailey Seth H. , Wieland Aaron M. , McCulloch Timothy M.
Published: May 2021

Objectives/Hypothesis

Airway access in the setting of unsuccessful ventilation and intubation typically involves emergent cricothyrotomy or tracheotomy, procedures with associated significant risk. The potential for such emergent scenarios can often be predicted based on patient and disease factors. Planned tracheotomy can be performed in these cases but is not without its own risks. We previously described a technique of pre‐tracheotomy or exposing the tracheal framework without entering the trachea, as an alternative to planned tracheostomy in such cases. In this way, a tracheotomy can be easily completed if needed, or the wound can be closed if it is not needed. This procedure has since been used in an array of indications. We describe the clinical situations where pre‐tracheotomy was performed as well as subsequent patient outcomes.

Methods

Retrospective series of patients undergoing a pre‐tracheotomy from 2015 to 2020. Records were reviewed for patient characteristics, indication, whether the procedure was converted to tracheotomy or closed at the bedside, and any post‐procedural complications.

Results

Pre‐tracheotomy was performed in 18 patients. Indications included failed extubation after head and neck reconstruction, subglottic stenosis, laryngeal masses, laryngeal edema, thyroid masses, and an oropharyngeal bleed requiring operative intervention. Tracheotomy was avoided in 10 patients with wound closed at the bedside; procedure was converted to tracheotomy in the remaining eight. There were no complications. Indications for conversion included failed extubation, intraoperative hemorrhage, significant stridor with dyspnea, and inability to ventilate.

Conclusion

Pre‐tracheotomy offers simplified airway access and provides a valuable option in scenarios where tracheotomy may, but not necessarily, be needed.

Level of Evidence

4 Laryngoscope, 131:E2802–E2809, 2021
Nitrate fluxes induced by turbulent mixing in dipole eddies in an oligotrophic ocean
Authors: Li Ruihuan , Xu Jie , Cen Xianrong , Zhong Wanxuan , Liao Jianzu , Shi Zhen , Zhou Shengqi
Published: May 2021

The vertical turbulent fluxes of nitrate to the base of the euphotic zone were quantified to assess the role of turbulent mixing in modulating new production inside cyclonic and anticyclonic eddies in an oligotrophic ocean. Although the turbulent nitrate flux (0.35 ± 0.11 mmol N m−2 d−1) at the base of the euphotic zone inside the cyclonic eddy was higher than that (0.07 ± 0.03 mmol N m−2 d−1) inside the anticyclonic eddy, this flux contributed to 19.7–76.3% of new production in the anticyclonic eddy and less than 4.94% in the cyclonic eddy, wherein new production was primarily driven by upwelling. Moreover, the turbulent nitrate flux in the cyclonic eddy center was higher than that at its edge because of differences in turbulent diffusivity. However, the opposite pattern appeared in the anticyclonic eddy, mainly due to discrepancies in the nitrate gradients and turbulent diffusivity. Elevated turbulent diffusivity at the edge of the anticyclonic eddy is the most likely attributed to submesoscale processes. These findings provide observatory evidence, confirming that a higher phytoplankton biomass exists in the anticyclonic eddy edge than in its center.
Occurrence and cycle of dimethyl sulfide in the western Pacific Ocean
Authors: Xu Feng , Yan Shi‐Bo , Zhang Hong‐Hai , Wu Ying‐Cui , Ma Qian‐Yao , Song Yu‐Chen , Zhuang Guang‐Chao , Yang Gui‐Peng
Published: May 2021

Oceanic production and occurrence of dimethyl sulfide (DMS) and its subsequent ventilation to the atmosphere significantly contribute to the global sulfur cycle and impact the climate regulation. Spatial distributions of DMS, dimethylsulfoniopropionate (DMSP, precursor of DMS), and dimethyl sulfoxide (DMSO, oxidation product of DMS), production and removal processes of DMS (including biological production, microbial consumption, photo‐degradation, and sea‐to‐air exchange), and biogenic contributions to the atmospheric sulfate burden were simultaneously studied in the western Pacific Ocean during winter. Sea surface DMS, DMSP, and DMSO were strongly correlated and had similar distribution patterns. The DMS photo‐degradation efficiency ratio (normalized using incident photon flux density) for ultraviolet B radiation (UVB): ultraviolet A radiation (UVA): photosynthetically active radiation (PAR) was 391: 36: 1. However, considering the solar spectral composition, the actual contributions of UVB, UVA, and PAR to DMS photo‐degradation in surface waters were 40.6% ± 10.7%, 41.2% ± 15.6%, and 18.2% ± 7.2%, respectively. When integrated across the entire mixed layer, UVA and PAR became the dominant drivers, accounting for 45.2% ± 18.0% and 38.0% ± 17.3% of DMS photo‐degradation, respectively, as UVB was significantly attenuated in seawater. The DMS budget of the entire mixed layer indicated that microbial consumption, photo‐degradation, and ventilation accounted for about 74.3% ± 11.9%, 19.3% ± 9.3%, and 6.5% ± 4.0% of total DMS removal, respectively. Even if ventilation was a minor DMS removal pathway, DMS emissions still contributed approximately 45.2% ± 25.6% of the atmospheric non‐sea‐salt sulfate burden over the western Pacific Ocean.
Multifunctional, Wash Durable and Re‐usable Conductive Textiles for Wearable Electro/Physiological Monitoring
Authors: Kisannagar Ravinder Reddy , Singh Mukesh , Gupta Dipti
Published: May 2021

Intelligent functionalities coupled textiles have received massive attention in the wearable health monitoring devices owing to their lightweight, ease of wearability, intrinsic flexibility, and comfortable texture. This article describes multifunctional, highly conductive, wash durable, and re‐usable reduced graphene oxide (RGO) coated polyester knitted textiles by a simple, cost effective, and scalable dip‐dry‐reduce approach and a novel approach to integrate as fabricated RGO coated polyester knitted textile (RGT) with the wearable elastic band for electro/physiological signal monitoring. The RGT exhibits high conductivity of 0.23 KΩ sq−1 and excellent wash durability. The RGT textile as a strain sensor shows a high sensitivity of 4.1 and 8 at a strain of 5% along the course and wale direction, respectively, stability and durability for more than 1500 cycles and also shows its excellent performance in human motion detection. Obtained electrophysiological signals from the RGT electrodes integrated wearable elastic band are comparable to those of the conventional Ag/AgCl electrodes. Owing to its comfortable texture, ease of wearability, stability, and wash durability, the RGT has potential applications in the future wearable electronic devices.
Quantitative Assessment of Response to Long‐Term Treatment with Intravenous Immunoglobulin in Patients with Stiff Person Syndrome
Authors: Bose Smriti , Thompson Joseph P. , Sadalage Girija , Karim Abid , Jacob Saiju
Published: May 2021

Background

Stiff person syndrome (SPS) is an autoimmune condition involving antibodies against several components of the inhibitory synapse in the spinal cord, with glutamic acid decarboxylase antibodies being the predominant immune marker. SPS affects approximately 1 patient per million population per year. The effect of intravenous immunoglobulin (IVIG) has been established, but studies on the long‐term efficacy of regular IVIG are limited.

Objectives

To review clinical details and long‐term treatment response using a patient‐reported questionnaire in SPS and related syndromes.

Methods

Patients were identified from a tertiary neuroimmunology clinic based on classical clinical symptoms, autoimmune profiles, and neurophysiological changes (Dalakas criteria). They were followed up after treatment to assess the response to IVIG.

Results

A total of 23 patients fulfilled the selection criteria. Patients' demographic profiles and clinical presentations were akin to that reported in literature. There was significant improvement in the functional ability (assessed by the modified Rankin scale [mRS]) and quality of life (QoL) following treatment with IVIG within 4 to 10 weeks (pre‐mRS vs. post‐mRS, P < 0.0001; pre‐QoL vs. post‐QoL, P = 0.0003) and sustained after 5 years of treatment (pre‐mRS vs. present mRS, P = 0.0003; pre‐QoL vs. present QoL, P = 0.0002).

Conclusions

This article describes one of the largest single‐center experiences of 23 patients with SPS and related syndromes and is the first to establish the long‐term efficacy of regular IVIG using a patient‐reported scoring system (Birmingham Response to Immunomodulatory Therapy [BRIT]). Consistent improvement in QoL and functional scores were seen over nearly 5 years after regular use of IVIG. It is recommended to use BRIT scores to assess the initial response as well as to monitor continued improvement to immunomodulation in SPS.
Dopaminergic and Serotonergic Degeneration and Cortical [18F]Fluorodeoxyglucose Positron Emission Tomography in De Novo Parkinson's Disease
Authors: Orso Beatrice , Arnaldi Dario , Girtler Nicola , Brugnolo Andrea , Doglione Elisa , Mattioli Pietro , Biassoni Erica , Fancellu Roberto , Massa Federico , Bauckneht Matteo , Chiola Silvia , Morbelli Silvia , Nobili Flavio , Pardini Matteo
Published: May 2021

Background

Degeneration of the nigrostriatal dopaminergic (DA) and the raphe‐thalamic serotonergic (SE) systems is among the earliest changes observed in Parkinson's disease (PD). The consequences of those changes on brain metabolism, especially regarding their impact on the cortex, are poorly understood.

Objectives

Using multi‐tracer molecular imaging, we assessed in a cohort of drug‐naive PD patients the association between cortical metabolism and DA and SE system deafferentation of either striatum or thalamus, and we explored whether this association was mediated by either striatum or thalamus metabolism.

Methods

We recruited 96 drug‐naive PD patients (aged 71.9 ± 7.5 years) who underwent [123I]ioflupane single‐photon emission computed tomography ([123I]FP‐CIT‐SPECT) and brain [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG‐PET). We used a voxel‐wise analysis of [18F]FDG‐PET images to correlate regional metabolism with striatal DA and thalamic SE innervation as assessed using [123I]FP‐CIT‐SPECT.

Results

We found that [123I]FP‐CIT specific to nondisplaceable binding ratio (SBR) and glucose metabolism positively correlated with one another in the deep gray matter (thalamus: P = 0.001, r = 0.541; caudate P = 0.001, r = 0.331; putamen P = 0.001, r = 0.423). We then observed a direct correlation between temporoparietal metabolism and caudate DA innervation, as well as a direct correlation between prefrontal metabolism and thalamus SE innervation. The effect of caudate [123I]FP‐CIT SBR values on temporoparietal metabolism was mediated by caudate metabolic values (percentage mediated: 89%, P‐value = 0.008), and the effect of thalamus [123I]FP‐CIT SBR values on prefrontal metabolism was fully mediated by thalamus metabolic values (P < 0.001).

Conclusions

These data suggest that the impact of deep gray matter monoaminergic deafferentation on cortical function is mediated by striatal and thalamic metabolism in drug‐naive PD. © 2021 International Parkinson and Movement Disorder Society
Linking Parkinson's Disease and Melanoma: Interplay Between α‐Synuclein and Pmel17 Amyloid Formation
Authors: Dean Dexter N. , Lee Jennifer C.
Published: May 2021

Parkinson's disease (PD) is a neurodegenerative disorder associated with the death of dopaminergic neurons within the substantia nigra of the brain. Melanoma is a cancer of melanocytes, pigmented cells that give rise to skin tone, hair, and eye color. Although these two diseases fundamentally differ, with PD leading to cell degeneration and melanoma leading to cell proliferation, epidemiological evidence has revealed a reciprocal relationship where patients with PD are more susceptible to melanoma and patients with melanoma are more susceptible to PD. The hallmark pathology observed in PD brains is intracellular inclusions, of which the primary component is proteinaceous α‐synuclein (α‐syn) amyloid fibrils. α‐Syn also has been detected in cultured melanoma cells and tissues derived from patients with melanoma, where an inverse correlation exists between α‐syn expression and pigmentation. Although this has led to the prevailing hypothesis that α‐syn inhibits enzymes involved in melanin biosynthesis, we recently reported an alternative hypothesis in which α‐syn interacts with and modulates the aggregation of Pmel17, a functional amyloid that serves as a scaffold for melanin biosynthesis. In this perspective, we review the literature describing the epidemiological and molecular connections between PD and melanoma, presenting both the prevailing hypothesis and our amyloid‐centric hypothesis. We offer our views of the essential questions that remain unanswered to motivate future investigations. Understanding the behavior of α‐syn in melanoma could not only provide novel approaches for treating melanoma but also could reveal insights into the role of α‐syn in PD. © 2021 International Parkinson and Movement Disorder Society
ET‐score: Improving Protein‐ligand Binding Affinity Prediction Based on Distance‐weighted Interatomic Contact Features Using Extremely Randomized Trees Algorithm
Authors: Rayka Milad , Karimi‐Jafari Mohammad Hossein , Firouzi Rohoullah
Published: May 2021

The molecular docking simulation is a key computational tool in modern drug discovery research that its predictive performance strongly depends on the employed scoring functions. Many recent studies have shown that the application of machine learning algorithms in the development of scoring functions has led to a significant improvement in docking performance. In this work, we introduce a new machine learning (ML) based scoring function called ET‐Score, which employs the distance‐weighted interatomic contacts between atom type pairs of the ligand and the protein for featurizing protein−ligand complexes and Extremely Randomized Trees algorithm for the training process. The performance of ET‐Score is compared with some successful ML‐based scoring functions and several popular classical scoring functions on the PDBbind 2016v core set. It is shown that our ET‐Score model (with Pearson's correlation of 0.827 and RMSE of 1.332) achieves very good performance in comparison with most of the ML‐based scoring functions and all classical scoring functions despite its extremely low computational cost. ET‐Score's codes are freely available on the web at https://github.com/miladrayka/ET_Score.
Real Paley‐Wiener theorem for the octonion Fourier transform
Authors: Li Yong , Ren Guangbin
Published: May 2021

For the octonion Fourier transform, we establish the real Paley‐Wiener theorem. It relates the mean of derivatives of a function with the support of its octonion Fourier transform via

for any octonion‐valued Sobolev function
.
A wideband high gain trapezoidal monopole antenna backed by frequency selective surface
Authors: Nguyen Duc Dung , Seo Chulhun
Published: May 2021

In this paper, a wideband, high gain planar trapezoidal monopole antenna based on single‐layer frequency selective surface (FSS) is presented. The antenna adopts an unconventional, dual‐metallic on a single‐layer FSS structure as a reflector layer to improve its performance. To validate the structure, the prototypes are fabricated and measured. The experimental results exhibit that the operating band of the proposed antenna covers 3.52–5.92 GHz, which corresponding to the impedance bandwidth of 50% with respect to the 5 GHz is the center frequency. Moreover, the proposed antenna offers a high gain with the maximum gain of 11.8 dBi at 5.1 GHz, and the gain is sustained higher 10.5 dBi for the entire bandwidth. The proposed antenna structure is a potential candidate for wideband applications and wireless local area network applications.
Context, design and conduct of the longitudinal COVID‐19 psychological research consortium study–wave 3
Authors: McBride Orla , Butter Sarah , Murphy Jamie , Shevlin Mark , Hartman Todd K. , Hyland Philip , McKay Ryan , Bennett Kate M. , Gibson‐Miller Jilly , Levita Liat , Mason Liam , Martinez Anton P. , Stocks Thomas VA , Vallières Frédérique , Karatzias Thanos , Valiente Carmen , Vazquez Carmelo , Bentall Richard P.
Published: May 2021

Objectives

The COVID‐19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID‐19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the ‘parent’ strand of the Consortium) during July‐August 2020.

Methods

Adults (N = 2025) who participated in the baseline and/or first follow‐up surveys were reinvited to participate in this survey, which assessed: (1) COVID‐19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public’s response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross‐sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK.

Results

1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re‐balanced the cross‐sectional sample to within 1% of population estimates across selected socio‐demographic characteristics.

Conclusion

This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic.
High‐contrast osteochondral junction imaging using a 3D dual adiabatic inversion recovery‐prepared ultrashort echo time cones sequence
Authors: Lombardi Alecio F. , Jang Hyungseok , Wei Zhao , Jerban Saeed , Wallace Mark , Masuda Koichi , Ma Ya‐Jun
Published: May 2021

While conventional MRI sequences cannot visualize tissues from the osteochondral junction (OCJ) due to these tissues' short transverse T2/T2* relaxations, ultrashort echo time (UTE) sequences can overcome this limitation. A 2D UTE sequence with a dual adiabatic inversion recovery preparation (DIR‐UTE) for selective imaging of short T2 tissues with high contrast has previously been developed, but high sensitivity to eddy currents and aliased out‐of‐slice excitation make it difficult to image the thin layer of the OCJ in vivo. Here, we combine the DIR scheme with a 3D UTE cones sequence for volumetric imaging of OCJ tissues in vivo, aiming to generate higher OCJ contrast compared with a recently developed single IR‐prepared UTE sequence with a fat saturation module (IR‐FS‐UTE). All sequences were implemented on a 3‐T clinical scanner. The DIR‐UTE cones sequence combined a 3D UTE cones sequence with two narrow‐band adiabatic IR preparation pulses centered on water and fat spectrum frequencies, respectively. The 3D DIR‐UTE cones sequence was first applied to a phantom, then to the knees of four healthy volunteers and four patients diagnosed with osteoarthritis and compared with the IR‐FS‐UTE sequence. In both phantom and volunteer studies, the proposed DIR‐UTE cones sequence showed much higher contrast for OCJ imaging than the IR‐FS‐UTE sequence did. The 3D DIR‐UTE cones sequence showed a significantly higher contrast‐to‐noise ratio between the OCJ and subchondral bone fat (mean, standard deviation [SD]: 25.7 ± 2.3) and between the OCJ and superficial layers of cartilage (mean, SD: 22.2 ± 3.5) compared with the IR‐FS‐UTE sequence (mean, SD: 10.8 ± 2.5 and 16.3 ± 2.6, respectively). The 3D DIR‐UTE cones sequence is feasible for imaging of the OCJ region of the knee in vivo and produces both high resolution and high contrast.
Development of a Competency Model for Placement and Verification of Nasogastric and Nasoenteric Feeding Tubes for Adult Hospitalized Patients
Authors: Powers Jan , Brown Britta , Lyman Beth , Escuro Arlene A. , Linford Lorraine , Gorsuch Kim , Mogensen Kris M. , Engelbrecht Jessica , Chaney Amanda , McGinnis Carol , Quatrara Beth A. , Leonard Jennifer , Guenter Peggi
Published: May 2021

Nasogastric/nasoenteric (NG/NE) feeding tube placements are associated with adverse events and, without proper training, can lead to devastating and significant patient harm related to misplacement. Safe feeding tube placement practices and verification are critical. There are many procedures and techniques for placement and verification; this paper provides an overview and update of techniques to guide practitioners in making clinical decisions. Regardless of placement technique and verification practices employed, it is essential that training and competency are maintained and documented for all clinicians placing NG/NE feeding tubes. This paper has been approved by the American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors.
Implementation Science and Nutrition: From Research to Practice
Authors: Brown Michelle , Rosenthal Martin , Yeh D. Dante
Published: May 2021

Implementation science (IS) is a young field that seeks to minimize the gap between what we know and what we practice, otherwise known as the “know‐do gap.” Recently, IS has focused on research that expedites the dissemination of evidence‐based knowledge, accelerates the translation of interventions to improve knowledge gaps, shrinks healthcare disparities, enhances care of complex medical conditions, and narrows variation in clinical practice and policy. This article seeks to review theoretical frameworks of IS and demonstrate how IS can be utilized to improve nutrition care. Specific examples in this article include implementation of initiatives to improve documentation of malnutrition, increase provision of oral nutrition supplements, increase use of Enhanced Recovery After Surgery protocols, and increase energy and protein delivery. Clinical nutrition is a growing field with more and more research findings pointing to new therapies. In implementing these new therapies, practitioners should recognize the complex system present in healthcare and lean on IS findings to speed implementation and more rapidly improve clinical outcomes.
Current trends in global nursing: A scoping review
Authors: Yatsu Hiroko , Saeki Akari
Published: May 2021

Aim

This review aimed to elucidate research trends in global nursing in international literature.

Design

A scoping literature review of the PRISMA was used to guide the review.

Methods

PubMed was used to search for English articles published in academic journals between 2016–2018. The search keywords were “global/international/world nursing.” We used thematic synthesis to analyse and interpret the data and generated topics for global nursing literature.

Results

In total, 133 articles were analysed. Six topics emerged: (a) conceptualization of global nursing, (b) environmental health, (c) infectious diseases, (d) security efforts, (e) global shortage of nursing personnel and (f) diversification of study abroad programmes. The results of this review reflect today's serious international health, labour and global environmental issues. Based on these latest global nursing topics, it is necessary to develop new strategies, nursing models and environment‐related theories to create and maintain a healthy environment.
Homologous Recombination Deficiency: Cancer Predispositions and Treatment Implications
Authors: Toh MingRen , Ngeow Joanne
Published: May 2021

Homologous recombination (HR) is a highly accurate DNA repair mechanism. Several HR genes are established cancer susceptibility genes with clinically actionable pathogenic variants (PVs). Classically, BRCA1 and BRCA2 germline PVs are associated with significant breast and ovarian cancer risks. Patients with BRCA1 or BRCA2 PVs display worse clinical outcomes but respond better to platinum-based chemotherapies and poly-ADP ribose polymerase inhibitors, a trait termed “BRCAness.” With the advent of whole-exome sequencing and multigene panels, PVs in other HR genes are increasingly identified among familial cancers. As such, several genes such as PALB2 are reclassified as cancer predisposition genes. But evidence for cancer risks remains unclear for many others. In this review, we will discuss cancer predispositions and treatment implications beyond BRCA1 and BRCA2, with a focus on 24 HR genes: 53BP1, ATM, ATR, ATRIP, BARD1, BLM, BRIP1, DMC1, MRE11A, NBN, PALB2, RAD50, RAD51, RAD51B, RAD51C, RAD51D, RIF1, RMI1, RMI2, RPA1, TOP3A, TOPBP1, XRCC2, and XRCC3.

Implications for Practice

This review provides a comprehensive reference for readers to quickly identify potential cancer predisposing homologous recombination (HR) genes, and to generate research questions for genes with inconclusive evidence. This review also evaluates the “BRCAness” of each HR member. Clinicians can refer to these discussions to identify potential candidates for future clinical trials.
Pilot evaluation of obesity‐specific health‐related quality of life following a 12‐week non‐randomized lifestyle intervention in youth
Authors: Randhawa Sukhbir , Randhawa Navkiran , Hassanin Es‐Haq , Yi‐Frazier Joyce P. , Briggs Early Kathaleen
Published: May 2021

Background

Health‐related quality of life (HRQOL), a multifaceted construct for understanding health and healthcare outcomes, is comprised of eight domains of well‐being and functioning over time and has become an essential factor in assessing outcomes for youth with obesity.

Aims

To evaluate the effect of a community based, lifestyle intervention, on obesity‐specific HRQOL using the Sizing Me Up (SMU) in this group of Latino and White youth.

Materials and Methods

For this 12‐week family and community‐based intervention (ACT; Actively Changing Together), HRQOL was measured before and after the intervention concluded using the obesity‐specific HRQOL tool, SMU. This study enrolled 68 youth (10.9 ± 2 years; 54% male; 50% non‐Hispanic white). Paired t‐tests were used to examine the Sizing Me Up sub‐scales: Emotion, Physical, Social Avoidance, Positive Attributes, Teasing, and the total score. A greater change score indicated a larger increase in quality of life sub‐scale.

Results

Significant improvements from baseline to follow‐up were found in the total SMU (mean change = 5.27, SD 10.76, p = 0.00) and for the sub‐scores of: emotion (mean change = 8.06, SD 16.85, p ≤ 0.00), teasing (mean change = 5.65, SD 16.79, p = 0.01), and social avoidance (mean change = 3.92, SD 11.21, p = 0.01).

Conclusions

Sizing Me Up provided a clinically meaningful tool for this research study to evaluate obesity‐specific HRQOL among Hispanic and non‐Hispanic White youth with obesity.